Shakery Sara, Nio Denise, Truijers Maarten
Department of Vascular Surgery, Spaarne Gasthuis, Haarlem, The Netherlands.
Department of Vascular Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
Vasc Endovascular Surg. 2025 May;59(4):442-446. doi: 10.1177/15385744251315998. Epub 2025 Feb 11.
PurposeThis report describes the use of a custom-made single-fenestrated endograft to preserve blood flow to the internal iliac artery (IIA) in a patient with an aorto-iliac aneurysm with unsuitable anatomy for a standard iliac branch device (IBD).Case ReportA 56-year-old man presented with an abdominal aortic aneurysm (AAA) of 56 mm involving the right common iliac artery (CIA). Use of a standard IBD for preservation of the IIA was deemed impossible due to narrow arrow anatomy of the right CIA. To preserve IIA flow, a custom-made Terumo endograft with an additional single-fenestration for the IIA was designed. The repair was successful and flow to the right IIA was preserved.ConclusionUsing a custom-made single-fenestrated endograft for the IIA in case of unsuitable anatomy for off-the-shelf IBDs prevents exclusion of the IIA and might prevent complications like buttock claudication and erectile dysfunction in patients with an aorto-iliac aneurysm. This report describes the use of a custom-made single fenestrated endograft to preserve blood flow to the IIA as a valuable alternative to standard iliac branched repair in patients with anatomical challenges.
目的
本报告描述了在一名患有主-髂动脉瘤且解剖结构不适合使用标准髂支装置（IBD）的患者中，使用定制的单开窗腔内移植物来保留髂内动脉（IIA）血流的情况。
病例报告
一名56岁男性，患有直径56mm的腹主动脉瘤（AAA），累及右髂总动脉（CIA）。由于右CIA解剖结构狭窄，使用标准IBD保留IIA血流被认为不可能。为保留IIA血流，设计了一种为IIA额外增加单开窗的定制泰尔茂腔内移植物。修复成功，右IIA血流得以保留。
结论
在解剖结构不适合现成IBD的情况下，使用为IIA定制的单开窗腔内移植物可避免IIA被隔绝，并可能预防主-髂动脉瘤患者出现诸如臀部间歇性跛行和勃起功能障碍等并发症。本报告描述了使用定制的单开窗腔内移植物来保留IIA血流，作为解剖结构有挑战的患者进行标准髂支修复的一种有价值的替代方法。
