Double-Barrel Technique With Reversed Gore Excluder Stent Graft Limb for Common Iliac Aneurysm Exclusion in a Patient With Prior Aortic Surgical Repair

Abstract

Surgical repair of a common iliac artery aneurysm (CIA) after previous open aortic reconstruction is associated with significant morbidity and mortality. Endovascular repair is considered less invasive than surgery. However, if preservation of the internal iliac artery (IIA) is required, the applicability of endovascular techniques may represent a challenge and a limitation to the use of standard aortic endografts or iliac branch devices. In these cases, the off-label use of endovascular devices may be an effective alternative. Herein, we report a successful hybrid approach to treat CIA using a reversed iliac limb endograft coupled with a double-barrel technique with femoro-femoral crossover bypass in a patient who had previously undergone open aortic reconstruction.

Reversed Gore Excluder conformable main body as a conduit between branched stent graft limb, common iliac artery, and renal artery

“…The technique to reverse a Gore Excluder iliac limb has been previously described. 1 , 2 , 3 Reversing a Gore Excluder Conformable main body is somewhat more complicated. We rehearsed the deployment with a demonstration stent graft device ( Supplementary Video 1 ).…”