Fenestrated/branched endovascular aortic repair using unilateral femoral access in patients with iliac occlusive disease

Rogers, Richard T.; Lemmens, Charlotte; Tenorio, Emanuel R.; Schurink, Geert-Willem; DeMartino, Randall R.; Oderich, Gustavo S.; Mees, Barend; Mendes, Bernardo C.

doi:10.1016/j.jvs.2022.10.049

Journal of Vascular Surgery

2023

DOI: 10.1016/j.jvs.2022.10.049

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Fenestrated/branched endovascular aortic repair using unilateral femoral access in patients with iliac occlusive disease

Richard T. Rogers

Charlotte Lemmens

Emanuel R. Tenorio

et al.

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Cited by 3 publications

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“…Endovascular repair has emerged as the first-line treatment option for patients with aortic aneurysms with significant short-term advantages compared with open repair. 1 , 2 , 3 , 4 , 5 , 6 Complex endovascular aortic aneurysm repair (EVAR) and thoracic endovascular aortic aneurysm repair (TEVAR) often require a large femoral access to advance the main device. The presence of narrow or diseased iliac and femoral arteries and tortuous access can preclude endovascular repair and increase the risk of access-related complications.…”

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“…Nevertheless, periprocedural complications, including bleeding, wound complications, delayed endovascular repair, and prolonged hospitalization, are not negligible. 6 , 10 , 11 , 12 In our practice, staged endoconduits (ECs) are extended through the common femoral artery (CFA) to improve access and avoid vascular injury at the future access site. We describe the “up-and-over” staged EC technique before complex EVAR.…”

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confidence: 99%

See 1 more Smart Citation

Up and over staged endoconduit technique for endovascular aortic aneurysm repair

Figueroa,

Tanenbaum,

Costa-Filho

et al. 2024

Journal of Vascular Surgery Cases, Innovations and Techniques

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mentioning

confidence: 99%

mentioning

confidence: 99%

Up and over staged endoconduit technique for endovascular aortic aneurysm repair

Figueroa,

Tanenbaum,

Costa-Filho

et al. 2024

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

Abdominal endovascular aneurysm repair using an aorto-uni-iliac device resulting in resting lower extremity pain: a case report and discussion on patient selection

Ekblad,

Hupp

2024

Journal of Surgical Case Reports

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Abdominal aortic aneurysms that meet criteria for repair are often managed with endovascular aneurysm repair using a bifurcated two-piece or bifurcated single-body stent. Patients with difficult anatomy, extensive calcifications, complete occlusion of common or external iliac artery, tortuous vessels, or small vessels may require placement of an Aorto-Uni-Iliac (AUI) stent graft. Placement of an AUI stent graft is typically combined with a femorofemoral crossover bypass to ensure adequate perfusion to the contralateral limb. In the elective setting, some literature now supports that select patients with unilateral occlusive common or external iliac disease may be treated with an AUI stent graft alone without femorofemoral crossover bypass. Here, we present a case of a 79-year-old female with an abdominal aortic aneurysms with unilateral occlusive iliac disease managed with an AUI stent graft who subsequently developed rest pain requiring a femorofemoral crossover bypass.

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Transvenous Access for Emergent Thoracic and Thoracoabdominal Aortic Aneurysm Repair in Patients Without Femoral Access

Grandi,

Gronert,

Panuccio

et al. 2023

J Endovasc Ther

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Purpose: To describe the technique of transvenous access for emergent endovascular repair of thoracic and thoracoabdominal aneurysms exemplified with 2 cases. Technique: Transvenous access to the aorta is described as an alternative access method to deliver aortic endografts in emergency situations. A 68-year-old female patient with severely compromised iliac and subclavian artery access was treated for a ruptured extent V thoraco-abdominal aortic aneurysm with a t-Branch (Cook Medical, Bjaeverskov, Denmark) delivered through a transcaval access. To avoid severe aortocaval shunting a balloon-expandable covered stent was deployed through a carotid access due to severe bilateral subclavian ostial stenosis. A 71-year-old man with an acute type B aortic dissection and bilateral narrow long-segment stenting of the iliac arteries was treated with a physician-modified thoracic endovascular aortic repair using an arteriovenous fenestration created at the level of the common iliac artery. We describe the access creation by fenestration using a transseptal needle. Conclusion: Transvenous access for thoracic and thoraco-abdominal aortic aneurysm repair is safe and feasible in selected emergent cases. Clinical Impact A transvenous approach may be helpful in selected patients when an endovascular repair needs to be performed but no arterial femoral access is available. This approach proved to be feasible even with large-bore introducer sheaths, taking its place in the armamentarium of the vascular surgeon for emergent complex endovascular aortic repairs.

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Fenestrated/branched endovascular aortic repair using unilateral femoral access in patients with iliac occlusive disease

Cited by 3 publications

References 31 publications

Up and over staged endoconduit technique for endovascular aortic aneurysm repair

Up and over staged endoconduit technique for endovascular aortic aneurysm repair

Abdominal endovascular aneurysm repair using an aorto-uni-iliac device resulting in resting lower extremity pain: a case report and discussion on patient selection

Transvenous Access for Emergent Thoracic and Thoracoabdominal Aortic Aneurysm Repair in Patients Without Femoral Access

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