Abstract
The authors describe femoral - internal iliac bypass creation to remove ischemic complications in aortoiliac aneurysm endovascular repair. Based on a good experience with bypass in 6 patients they recommend its preventive indication when both internal iliac arteries are overstented.
Highlights
Indication for abdominal aortic aneurysm (AAA) endovascular repair (EVAR) depends on AAA morphology
Extension of the aneurysm to the iliac bifurcation is considered to be one of the exclusion criteria for EVAR3
The stentgraft must be extended into the external iliac artery
Summary
Indication for abdominal aortic aneurysm (AAA) endovascular repair (EVAR) depends on AAA morphology. In patient selection for endovascular grafting helps AAA morphological classification[1, 2]. Extension of the aneurysm to the iliac bifurcation ( aortoiliac AAA of type II C according to Schumacher – type D,E to EUROSTAR classification) is considered to be one of the exclusion criteria for EVAR3. The internal iliac artery is excluded from the direct blood flow and its origin must be occluded to prevent retrograde endoleak. Artificial occlusion of to this time open both internal iliac arteries may be tolerated, but with concomitant exclusion of inferior mesenteric artery and lumbal arteries by aortic stentgraft the risk of severe. Device across the internal iliac artery origin. In 12 of these patients (AAA of type II C/2 ) the internal iliac artery origin was overstented and occluded on both sides (Fig. 1, 2). All the bypasses are primarily patent to date and the patients are ischemic symptom free (Fig. 5)
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