An Abdominal Aortic Endoprosthesis as an Iliac Branch Device for the Preservation of Common Iliac and Internal Iliac Arteries in a Patient with a Common and Internal Arteries Aneurysm and a Type B Aortic Dissection

Abstract

Introduction: An iliac artery aneurysm (IAA) is characterized by an increase in the vessel's diameter of more than 1.5 times that of normal. There are numerous similarities between iliac and aortic aneurysms in terms of their natural histories, risk factors, and key treatment philosophies. Objectives: To report the use of an abdominal aortic endoprosthesis as an iliac branch device in a patient with a type B aortic dissection, multiple comorbidities, and aneurysm of the abdominal aorta and the right common and internal iliac arteries. Methods: Male patient, 58, brought to hospital with type B aortic dissection and other comorbidities. The patient was released after a successful TEVAR procedure in which we implanted 1 thoracic endoprosthesis and 2 thoracic segments. A post-TEVAR CT is taken, and EVAR (endovascular aneurysm repair) planning is completed. In order to do the EVAR surgery, we inserted a covered stent and a 23mmx14mmx18cm abdominal aortic endoprosthesis into the right common iliac artery to act as an iliac branch device. There are no endoleaks in the final aortography. Results: The treatment was successful, and there is no sign of any problems in the control CT and improvement in the patient’s quality of life. Conclusions: An aortic abdominal endoprosthesis can work well as an iliac branch device despite the existence of other iliac branch devices. With adequate preparation, the two-stage operation can enhance the results for patients with type B aortic dissection.