In Situ Fenestration Through the Contralateral Iliac Artery to Convert an Aortouni-iliac Into a Bifurcated Endograft. (June 2015)

• Record Type: Journal Article
• Authors: Coscas, Raphaël; Glorion, Matthieu; Javerliat, Isabelle; Goëau-Brissonniere, Olivier; Coggia, Marc
• Is Part Of: Journal of endovascular therapy. Volume 22:Number 3(2015:Jun.)
• Page Start: 421
• Page End: 425
• Publication Date: 2015-06
• Subjects: in situ fenestration -- aortouni-iliac endograft -- stent-graft -- bifurcated stent-graft -- endovascular aneurysm repair -- abdominal aortic aneurysm -- kissing stents; 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: 10.1177/1526602815583492
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To present a technique of in situ fenestration that allows conversion of an aortouni-iliac endograft into a bifurcated endograft, thereby avoiding crossover femorofemoral bypass and its complications.Technique: Following conventional deployment of an aortouni-iliac endograft, in situ fenestration through the contralateral common iliac artery is performed with a transjugular intrahepatic access set. The fabric hole is enlarged using a cutting balloon and a high-pressure noncompliant balloon. Kissing iliac-covered stents are then positioned at the level of the bifurcation to convert the aortouni-iliac endograft into a bifurcated repair. To date, this technique has been successfully used in 4 patients with satisfactory short-term results.Conclusion: This technique represents another application of endograft in situ fenestration. This strategy provides a bifurcated repair in cases where bifurcated stent-grafts are usually precluded, such as a narrow distal aorta, ruptured abdominal aortic aneurysm, or combined aortoiliac occlusive disease.