A novel hybrid approach to the treatment of common iliac aneurysms: Antegrade endovascular hypogastric stent grafting and femorofemoral bypass grafting

Luis R. Leon, Joseph L Mills, Shemuel B. Psalms, Kaoru Goshima, Son T. Duong, Chidi Ukatu

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

A progressively enlarging left common iliac artery aneurysm developed in a 72-year-old man 7 years after open abdominal aortic aneurysm repair with a bifurcated Dacron graft. Because both the right hypogastric and inferior mesenteric arteries had been ligated at the initial operation, preservation of left hypogastric flow was critical to avoid pelvic or intestinal ischemia. He was a poor open surgical candidate owing to obesity, a hostile abdomen, and multiple medical comorbidities. Therefore, a novel hybrid approach was used consisting of left transbrachial selective left hypogastric artery catheterization, followed by deployment of two, overlapping, antegrade, covered stent grafts extending from the proximal left graft limb into the left hypogastric artery. A right-to-left femorofemoral crossover bypass was added to perfuse the left lower extremity and was performed in end-to-end fashion to the left common femoral artery to exclude and prevent retrograde flow into the iliac aneurysm. Also presented are potential procedural pitfalls and a detailed review of open, endovascular and hybrid options to preserve hypogastric flow when treating iliac aneurysms in complex, high-risk patients.

Original languageEnglish (US)
Pages (from-to)1244-1248
Number of pages5
JournalJournal of Vascular Surgery
Volume45
Issue number6
DOIs
StatePublished - Jun 2007

Fingerprint

Iliac Aneurysm
Stents
Transplants
Arteries
Inferior Mesenteric Artery
Polyethylene Terephthalates
Iliac Artery
Abdominal Aortic Aneurysm
Femoral Artery
Catheterization
Abdomen
Comorbidity
Lower Extremity
Therapeutics
Ischemia
Extremities
Obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

A novel hybrid approach to the treatment of common iliac aneurysms : Antegrade endovascular hypogastric stent grafting and femorofemoral bypass grafting. / Leon, Luis R.; Mills, Joseph L; Psalms, Shemuel B.; Goshima, Kaoru; Duong, Son T.; Ukatu, Chidi.

In: Journal of Vascular Surgery, Vol. 45, No. 6, 06.2007, p. 1244-1248.

Research output: Contribution to journalArticle

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