Preservation of Internal Iliac Artery after Endovascular Repair of Common Iliac Artery Dissection Using Modified Fenestrated Stent Graft

Abstract

Standard endovascular repair of iliac/aortoiliac pathologies can lead to complications, such as buttock claudication, colon ischemia and erectile dysfunction. Branch grafts have been developed but require at least 6 weeks for customization and are not currently available in China; they are also quite expensive. To our knowledge, modified fenestrated stent grafts (MFSGs) are a safe and effective alternative for treating patients with juxtarenal aneurysms. Most MFSGs are used for the preservation of renal and left subclavian arteries. Few cases of MFSGs have been reported in the treatment of iliac pathologies. The use of an MFSG is decided on a case-by-case basis. This report presents our first clinical use of an MFSG for preservation of the internal iliac artery.

Effectiveness of the conservative therapy for spontaneous isolated iliac artery dissection: Preliminary results

“…3,4,6 Although patients with SIIAD can be resolved spontaneously without specific treatment or in stable condition, 7 the progress to true lumen occlusion, false lumen expansion, aneurysmal dilation, and iliac artery rupture have been reported. 3,4,6 The primary objective of treatment of SIIAD is to limit the extension of dissection, to preserve the blood flow distally through the true lumen, and to prevent the artery rupture. Conservative treatment, endovascular treatment and surgical treatment were reported in the management of SIIAD.…”

“…Conservative treatment, endovascular treatment and surgical treatment were reported in the management of SIIAD. 3,4,6 There is currently no consensus regarding optimal management of SIIAD. 10…”

“…Endovascular therapy has been reported in the treatment of patients with SIIAD, and can be reserved for patients who failed conservative therapy. 3,6 Although endovascular stent placement provided immediate symptomatic improvement and prevented further progression of the false lumen, 3,6 there are many drawbacks of stent placement, including stent restenosis and obliteration of side branches of the iliac artery.…”

“…1,2 Spontaneous isolated iliac artery dissection (SIIAD), an iliac artery dissection without the presence of the aortic dissection, is an uncommon but potentially catastrophic pathology. 3–5 The natural history of SIIAD is unpredictable. 3,4,6 Although several case of SIIAD have been reported, 5,7 there is no clinical study about SIIAD has been reported.…”

“…3–5 The natural history of SIIAD is unpredictable. 3,4,6 Although several case of SIIAD have been reported, 5,7 there is no clinical study about SIIAD has been reported. Although several treatment options, including conservative treatment, endovascular treatment, and surgical treatment are available.…”