Yu Sz-Han, Wu I-Hui
Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
College of Medicine, National Taiwan University, Taipei, Taiwan.
SAGE Open Med Case Rep. 2024 Aug 27;12:2050313X241275848. doi: 10.1177/2050313X241275848. eCollection 2024.
Coexistent aneurysmal involvement of common iliac artery is frequently seen in patients with infrarenal abdominal aortic aneurysm. Bilateral iliac branch devices are an option to preserve bilateral internal iliac arteries in order to decrease the risk of buttock claudication. In Asian population, however, the aortoiliac lengths are commonly not adequate for bilateral iliac branch endoprosthesis. In this technical note, we use a novel hybrid technique to preserve bilateral internal iliac arteries in a patient without adequate aortoiliac length for bilateral iliac branch endoprosthesis. The right internal iliac artery is preserved with iliac branch endoprosthesis. The left internal iliac artery is preserved with cross-over chimney stent grafts which are deployed simultaneously with the parallel grafting of iliac extension from the contralateral gate to the right iliac branch endoprosthesis. Follow-up computed tomography and three-dimensional angiography showed complete aneurysm exclusion with flow preservation to bilateral internal iliac arteries.
肾下腹主动脉瘤患者常并存髂总动脉瘤累及。双侧髂支装置是一种保留双侧髂内动脉以降低臀部间歇性跛行风险的选择。然而，在亚洲人群中，主动脉髂动脉长度通常不足以容纳双侧髂支内假体。在本技术说明中，我们使用一种新型混合技术，在一名主动脉髂动脉长度不足以容纳双侧髂支内假体的患者中保留双侧髂内动脉。右侧髂内动脉通过髂支内假体保留。左侧髂内动脉通过交叉烟囱支架移植物保留，该支架移植物与从对侧入口到右侧髂支内假体的髂动脉延伸段平行移植同时部署。随访计算机断层扫描和三维血管造影显示动脉瘤完全被排除，双侧髂内动脉血流得以保留。
