Abstract
We are pleased that you are interested in our report on the endoconduit.1Peterson B.G. Matsumura J.S. Internal endoconduit: an innovative technique to address unfavorable iliac artery anatomy encountered during thoracic endovascular aortic repair.J Vasc Surg. 2008; 47: 441-445Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar In the two subsequent cases mentioned in the case report, the hypogastric arteries were patent, as they have been in two out of three cases utilizing the endoconduit since submission of the original manuscript. We understand your concern regarding back-bleeding from a patent hypogastric artery using the endoconduit technique, but in our experience, the endoconduit alone seems to prevent back-bleeding; and therefore, we do not consider a patent hypogastric artery to be an absolute contraindication to using an endoconduit. Similar findings have been reported in the literature when one considers the absence of type II endoleak with hypogastric artery orifice coverage without coil embolization during the endovascular management of aortoiliac aneurysms.2Tefera G. Turnipseed W.D. Carr S.C. Pulfer K.A. Hoch J.R. Acher C.W. Is coil embolization of hypogastric artery necessary during endovascular treatment of aortoiliac aneurysms?.Ann Vasc Surg. 2004; 18: 143-146Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar In our cases, the controlled ruptures have seemed to take place in the mid-external iliac artery. However, if the area of stenosis that mandates the use of an endoconduit is adjacent to the hypogastric origin and rupture is anticipated in this area, a preemptive strategy of embolizing the hypogastric main trunk when it is patent could be useful to prevent back-bleeding. Once again, we appreciate your interest in our article. We hope that this technique helps you and others address unfavorable iliac anatomy during aortic endovascular procedures, and we agree that larger series are needed to draw definitive conclusions regarding the safety of this technique. Regarding “Internal endoconduit: An innovative technique to address unfavorable iliac artery anatomy encountered during thoracic endovascular aortic repair”Journal of Vascular SurgeryVol. 48Issue 1PreviewWe read with great interest the article of Peterson and Matsumura1 concerning an innovative technique to deal with unfavorable iliac artery anatomy during thoracic endovascular aortic repair (TEVAR). This technique allows for the safe passage of large-profile delivery sheaths during TEVAR by means of the deployment of an iliac stent graft, followed by angioplasty and controlled rupture of the iliac artery. We have found this technique extremely ingenious and simple, although we agree with the authors that a larger series needs to be examined before any conclusions can be made about the safety of this technique. Full-Text PDF Open Archive
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
