Modified “Stent-Graft Sandwich” Technique for Treatment of Isolated Common Iliac Artery Aneurysm in Patient With Marfan Syndrome

Yoshida, Ricardo de Alvarenga; Yoshida, Winston Bonetti; Kolvenbach, Ralf; Vieira, Paulo Roberto Bahdur

doi:10.1016/j.avsg.2011.10.015

Cited by 9 publications

(6 citation statements)

References 11 publications

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“…So far, there have been only a small number of case reports on the sandwich technique for preserving IIA blood flow. All reported technical access and excellent short-midterm outcomes have been without significant complications 12-15). Ricci et al16) demonstrated that the sandwich stent graft was still patent at the 1-year follow-up.…”

Section: Discussionmentioning

confidence: 97%

Endovascular Repair of Aortoiliac Aneurysm Using Bifurcated Stent Grafts with Sandwich Technique for Preserving the Internal Iliac Artery

Kim

Lee

et al. 2013

Korean Circ J

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In this case, we describe a case of a 76-year-old male with extensive aortoiliac aneurysms treated by endovascular aneurysm repair using the sandwich technique in order to preserve left internal iliac artery perfusion. The sandwich technique refers to the deployment of multiple paralleled stent grafts into main distal and side branches in overlapping with a single proximal stent graft. The procedure was successfully performed without complications. Post-procedural CT angiography demonstrated patent stent grafts without any endoleak. The strengths and limitations of the sandwich technique need to be investigated in large-scale, long-term clinical trials.

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Section: Discussionmentioning

confidence: 97%

Endovascular Repair of Aortoiliac Aneurysm Using Bifurcated Stent Grafts with Sandwich Technique for Preserving the Internal Iliac Artery

Kim

Lee

et al. 2013

Korean Circ J

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“…3,20 For hypogastric side branch non-feasibility, a barrel technique could be also considered. 21,22 If the iliac artery is short but not dilated, it may be useful to consolidate the distal sealing by deploying an uncovered stent to the external iliac artery. The hypogastric artery exclusion with distal sealing in the external iliac artery can be considered in poor surgical risk patients with hostile hypogastric anatomy, particularly if a patent contralateral hypogastric artery is present, but taking into consideration the risk of pelvic complications 3,23 associated with this kind of approach.…”

Section: Discussionmentioning

confidence: 99%

Planning and Endograft Related Variables Predisposing to Late Distal Type I Endoleaks

Mascoli

Faggioli

Gallitto

et al. 2019

European Journal of Vascular and Endovascular Surgery

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This paper underlines that distal type I endoleak is not negligible during long term follow up after EVAR and reintervention is always required but can be performed endovascularly in the most of cases. Moreover, in this experience we report that the presence of a distal oversize < 10% and a reduced coverage of the common iliac artery are risk factors for distal type I endoleak and it suggests that planning is crucial to reduce the development of this complication.Objective: Late distal type I endoleak (ELIB) hampers the outcome of endovascular repair (EVAR) for abdominal aortic aneurysm (AAA); however, only few dedicated experiences have been reported in the literature. The aim of the study was to evaluate the incidence, presentation and treatment of late ELIB and to identify possible anatomical and technical predictors. Methods: All patients undergoing elective EVAR between 2008 and 2013 were collected prospectively. Follow up was by post-operative computed tomography angiography (CTA) performed within 30 days and CTA and/or duplex ultrasound (DUS) at six or 12 months and yearly thereafter. Patients with late ELIB, defined as distal type I endoleak detected more than six months after the primary intervention without endoleak on the intraoperative completion angiogram and on the post-operative CTA, were retrospectively selected (G1) and compared with a control group with no ELIB (G2) homogeneous for clinical conditions, endograft implanted, and timing of follow up. The minimum follow up required for inclusion in the study was 24 months. Preoperative morphological aorto-iliac features and EVAR implant details were evaluated, and measurements performed after centre lumen line reconstructions using dedicated software. The differences between G1 and G2 were analysed using the chi-square test, the Student t test, and logistic regression. Results: Six hundred and sixteen patients were submitted to EVAR. ELIB was detected in 14 cases (2.3%) (G1) at a median follow up of 32.8 (IQR 48) months. In three of the 14 cases ELIB was symptomatic (AAA rupture, 2; pain, 1); in the remaining 11 cases it was asymptomatic and found incidentally at routine follow up. Treatment was by open repair in one case and by endovascular iliac leg extension in 13 cases. Hypogastric exclusion was necessary in two of 14 cases. Thirty patients were included in G2, with a median follow up of 41.2 (25) months. Common iliac artery length <4 cm (OR 5.3, 95% CI 1.1e29.5, p ¼ .05), diameter > 15 mm (OR 3.5, 95% CI 1.2e10.9, p ¼ .03), and severe thrombotic apposition (>50% of circumference) (OR 5, 95% CI 1.2e19.2, p ¼ .02), at the iliac sealing zone were significant predictors of ELIB, on univariable analysis; oversizing of the iliac leg diameter < 10% and distal sealing > 1 cm above the hypogastric origin were independently associated with ELIB (OR 5.4, 95% CI 1.3e21.5, p ¼ .01 and OR 6.6, 95% CI 1.1e39.3, p ¼ .03, respectively), on multivariable analysis. Conclusion:The present data underline that ELIB is a non-negligible occurrence during long term EVA...

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“…The sandwich technique was introduced to offer an endovascular off-the-shelf solution to patients with TAAA as an alternative to a custom-made device [50,51]. Initially described in the treatment of aortoiliac disease, it combines the principles of a chimney graft with aneurysm exclusion by using several aortic stent grafts overlapped [52]. A chimney graft runs parallel to an aortic stent graft into the visceral or renal vessel, and there is a direct contact between the chimney graft and the aortic wall.…”

Section: Parallel Endograftingmentioning

confidence: 99%

Toward an Entirely Endovascular World for Thoracoabdominal Aortic Disease: Myth or Reality?

Cao¹,

Ferrer

2019

Visceral Vessels and Aortic Repair

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Modified “Stent-Graft Sandwich” Technique for Treatment of Isolated Common Iliac Artery Aneurysm in Patient With Marfan Syndrome

Cited by 9 publications

References 11 publications

Endovascular Repair of Aortoiliac Aneurysm Using Bifurcated Stent Grafts with Sandwich Technique for Preserving the Internal Iliac Artery

Endovascular Repair of Aortoiliac Aneurysm Using Bifurcated Stent Grafts with Sandwich Technique for Preserving the Internal Iliac Artery

Planning and Endograft Related Variables Predisposing to Late Distal Type I Endoleaks

Toward an Entirely Endovascular World for Thoracoabdominal Aortic Disease: Myth or Reality?

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