Tailor-made iliac branched device for preserving the internal iliac artery in patients with common iliac artery aneurysm

Po-Lin Chen, Hung-Lung Hsu, I-Ming Chen, Tzu-Ting Kuo, Yin-Yin Chen, Chun-Che Shih

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Endovascular repair with stent-graft is a treatment option for patient with common iliac artery aneurysm (CIAA). However, the preservation of the internal iliac artery (IIA) is a concern. The commercially available iliac branched device (IBD) requires a common iliac length of at least 5 cm, which is usually too long for Asian people. Here, we report our medium-term results of using tailor-made IBD for patients with short common iliac artery (CIA) with and without abdominal aortic aneurysm (AAA).

METHODS: A selected iliac limb of the AAA stent-graft was unloaded from the delivery system. A 6-mm fenestration hole was made at the length of the CIA from the proximal end. The edge of the hole was reinforced with the soft and radiopaque tip of a 0.014´´ wire. Then, the iliac limb was reloaded into the introduced sheath as the tailor-made IBD. It was inserted from the selected side of the femoral artery and deployed. The ipsilateral IIA was cannulated through the fenestration hole. Then, a balloon-expandable or self-expandable covered stent with an appropriate size was deployed as the bridging stent-graft.

RESULTS: Between March 2013 and March 2017, a total of 10 patients received the tailor-made IBDs. One patient died of systemic thromboembolism 2 days after the operation. The bridging stent-grafts remained patent in all patients, except one occluded at 1 year after operation.

CONCLUSION: A tailor-made IBD is an easy-to-apply, alternative option for preserving the IIA perfusion in short CIAA patients with and without AAA.

Original languageEnglish
Pages (from-to)710-713
Number of pages4
JournalJournal of the Chinese Medical Association : JCMA
Volume82
Issue number9
DOIs
Publication statusPublished - Jan 1 2019
Externally publishedYes

Fingerprint

Iliac Aneurysm
Iliac Artery
Stents
Equipment and Supplies
Abdominal Aortic Aneurysm
Transplants
Extremities
Thromboembolism
Femoral Artery
Perfusion

Keywords

  • Abdominal aortic aneurysm
  • Common iliac artery aneurysm
  • Endovascular aneurysm repair
  • Iliac branched device
  • Internal iliac artery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tailor-made iliac branched device for preserving the internal iliac artery in patients with common iliac artery aneurysm. / Chen, Po-Lin; Hsu, Hung-Lung; Chen, I-Ming; Kuo, Tzu-Ting; Chen, Yin-Yin; Shih, Chun-Che.

In: Journal of the Chinese Medical Association : JCMA, Vol. 82, No. 9, 01.01.2019, p. 710-713.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Endovascular repair with stent-graft is a treatment option for patient with common iliac artery aneurysm (CIAA). However, the preservation of the internal iliac artery (IIA) is a concern. The commercially available iliac branched device (IBD) requires a common iliac length of at least 5 cm, which is usually too long for Asian people. Here, we report our medium-term results of using tailor-made IBD for patients with short common iliac artery (CIA) with and without abdominal aortic aneurysm (AAA).METHODS: A selected iliac limb of the AAA stent-graft was unloaded from the delivery system. A 6-mm fenestration hole was made at the length of the CIA from the proximal end. The edge of the hole was reinforced with the soft and radiopaque tip of a 0.014´´ wire. Then, the iliac limb was reloaded into the introduced sheath as the tailor-made IBD. It was inserted from the selected side of the femoral artery and deployed. The ipsilateral IIA was cannulated through the fenestration hole. Then, a balloon-expandable or self-expandable covered stent with an appropriate size was deployed as the bridging stent-graft.RESULTS: Between March 2013 and March 2017, a total of 10 patients received the tailor-made IBDs. One patient died of systemic thromboembolism 2 days after the operation. The bridging stent-grafts remained patent in all patients, except one occluded at 1 year after operation.CONCLUSION: A tailor-made IBD is an easy-to-apply, alternative option for preserving the IIA perfusion in short CIAA patients with and without AAA.",
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AU - Chen, Yin-Yin

AU - Shih, Chun-Che

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N2 - BACKGROUND: Endovascular repair with stent-graft is a treatment option for patient with common iliac artery aneurysm (CIAA). However, the preservation of the internal iliac artery (IIA) is a concern. The commercially available iliac branched device (IBD) requires a common iliac length of at least 5 cm, which is usually too long for Asian people. Here, we report our medium-term results of using tailor-made IBD for patients with short common iliac artery (CIA) with and without abdominal aortic aneurysm (AAA).METHODS: A selected iliac limb of the AAA stent-graft was unloaded from the delivery system. A 6-mm fenestration hole was made at the length of the CIA from the proximal end. The edge of the hole was reinforced with the soft and radiopaque tip of a 0.014´´ wire. Then, the iliac limb was reloaded into the introduced sheath as the tailor-made IBD. It was inserted from the selected side of the femoral artery and deployed. The ipsilateral IIA was cannulated through the fenestration hole. Then, a balloon-expandable or self-expandable covered stent with an appropriate size was deployed as the bridging stent-graft.RESULTS: Between March 2013 and March 2017, a total of 10 patients received the tailor-made IBDs. One patient died of systemic thromboembolism 2 days after the operation. The bridging stent-grafts remained patent in all patients, except one occluded at 1 year after operation.CONCLUSION: A tailor-made IBD is an easy-to-apply, alternative option for preserving the IIA perfusion in short CIAA patients with and without AAA.

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KW - Abdominal aortic aneurysm

KW - Common iliac artery aneurysm

KW - Endovascular aneurysm repair

KW - Iliac branched device

KW - Internal iliac artery

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