Implantation of an Iliac Branch Device After EVAR via a Femoral Approach Using a Steerable Sheath. (August 2015)

• Record Type: Journal Article
• Authors: Oberhuber, Alexander; Duran, Mansur; Ertaş, Neslihan; Simon, Florian; Schelzig, Hubert
• Is Part Of: Journal of endovascular therapy. Volume 22:Number 4(2015:Aug.)
• Page Start: 610
• Page End: 612
• Publication Date: 2015-08
• Subjects: abdominal aortic aneurysm -- stent-graft -- iliac branch -- iliac aneurysm -- endovascular aneurysm repair -- steerable sheath -- femoral approach; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602815590972
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To describe a contralateral femoral approach for iliac branch device implantation using a steerable sheath in the setting of an existing bifurcated stent-graft.Technique: The method is demonstrated in an 80-year-old man who developed a 4-cm iliac aneurysm 3 years after implantation of an Endurant bifurcated stent-graft. Both femoral arteries were cannulated after surgical cutdown. The steerable sheath was advanced from the contralateral side over the neobifurcation of the bifurcated stent-graft. A 0.014-inch Roadrunner wire was used as a through-and-through wire to stabilize the curve of the sheath and to get proper push. The bridging stent-graft for the iliac branch was advanced over this sheath to seal the iliac aneurysm. During the entire procedure, the sheath was stable over the neobifurcation without pulling it down.Conclusion: The contralateral femoral approach for iliac branch graft implantation is feasible in cases with an extant bifurcated stent-graft using a steerable sheath and a through-and-through wire.