Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms Osvaldo J. Yano, MD, Nicholas Morrissey, MD, Leon.

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Presentation transcript:

Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms Osvaldo J. Yano, MD, Nicholas Morrissey, MD, Leon Eisen, MD, Peter L. Faries, MD, Krish Soundararajan, MD, Stephen Wan, BA, Victoria Teodorescu, MD, Morris Kerstein, MD, Larry H. Hollier, MD, Michael L. Marin, MD Journal of Vascular Surgery Volume 34, Issue 2, Pages 204-211 (August 2001) DOI: 10.1067/mva.2001.115380 Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 A, Direct revascularization of IIA. B, Sacrifice of IIA by embolization. Both methods allow a more distal deployment of stent-graft, with complete aneurysm exclusion from circulation. Journal of Vascular Surgery 2001 34, 204-211DOI: (10.1067/mva.2001.115380) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Various devices used as means of occluding IIA (upper row ) accompanied by their angiograms (lower row ). A, Coil embolization by means of Gianturco stainless steel stents. Completion angiogram showing thrombosis of the IIA. B, Amplatz vascular obstructing device (Spider) used as anchor to coil embolization stents, accompanied by angiogram. C, Detachable balloon occluder and its angiographic appearance. D, Iliac limb stent-graft deployed over origin of the IIA. Journal of Vascular Surgery 2001 34, 204-211DOI: (10.1067/mva.2001.115380) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Illustration of pertinent pelvic circulation. AAA, Abdominal aortic aneurysm; CFA, common femoral artery; DCI, deep iliac circumflex artery; DFA, deep femoral artery; EI, external iliac artery; IE, inferior epigastric artery; IG, inferior gluteal artery; IIA, internal iliac artery; IL, iliolumbar artery; IMA, inferior mesenteric artery; IP, inferior pudendal artery; LFC, lateral femoral circumflex artery; L, fourth and fifth lumbar artery; LS, lateral sacral artery; MFC, medial femoral circumflex artery; MS, middle sacral artery; O, obturator artery; SF, superficial femoral artery; SH, superior hemorrhoidal; SCI, superior circumflex iliac artery; SG, superior gluteal artery. Journal of Vascular Surgery 2001 34, 204-211DOI: (10.1067/mva.2001.115380) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Angiogram demonstrating stenotic IIA and absence of many of its branches. There are also numerous small caliber unnamed collateral vessels. Journal of Vascular Surgery 2001 34, 204-211DOI: (10.1067/mva.2001.115380) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Angiogram demonstrating stenosis of the common femoral artery and its bifurcation. Note the absence of the deep femoral artery ascending branches to the pelvis. Journal of Vascular Surgery 2001 34, 204-211DOI: (10.1067/mva.2001.115380) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions