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Successful off-label use of the GORE EXCLUDER Iliac Branch Endoprosthesis to preserve gluteal perfusion during staged endovascular repair of bilateral.

Published byJessie Elmer Lyons Modified over 5 years ago

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Presentation on theme: "Successful off-label use of the GORE EXCLUDER Iliac Branch Endoprosthesis to preserve gluteal perfusion during staged endovascular repair of bilateral."— Presentation transcript:

1 Successful off-label use of the GORE EXCLUDER Iliac Branch Endoprosthesis to preserve gluteal perfusion during staged endovascular repair of bilateral isolated hypogastric aneurysms  James W. Cornwall, MD, Daniel K. Han, MD, Daniel I. Fremed, MD, Peter L. Faries, MD, Ageliki G. Vouyouka, MD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 3, Issue 1, Pages (March 2017) DOI: /j.jvscit Copyright © 2016 The Author(s) Terms and Conditions

2 Fig 1 A-C, Computed tomography angiogram and (D-F) intraoperative angiogram on the day of initial presentation. A, Large 5.5-cm right and 3.5-cm left isolated iliac artery aneurysms are demonstrated. Measurements were infrarenal aorta diameter, 2.0 cm; the right common iliac artery, 1.6 cm; left common iliac artery, 1.6 cm; right external iliac artery, 1.1 cm; left external iliac artery, 1.0 cm; and left gluteal artery, 0.6 cm. B, At 2 cm distal to A, the left hypogastric artery aneurysm (red arrow) is better visualized. C, Contained rupture of the right internal iliac artery with free fluid in the retroperitoneum. D, Right hypogastric aneurysm with active extravasation after selective catheterization of the right internal iliac. The red arrow is pointing to the cavity of the aneurysm with extravasation. E, Contained rupture after embolization of the anterior and posterior division of the internal iliac. F, Exclusion of right internal iliac aneurysm after further embolization and endograft placement. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 37-40DOI: ( /j.jvscit ) Copyright © 2016 The Author(s) Terms and Conditions

3 Fig 2 Intraoperative angiogram from elective repair of left hypogastric aneurysms with GORE EXCLUDER Iliac Branch Endoprosthesis (IBE; W. L. Gore and Associates, Flagstaff, Ariz) device. A, Intraoperative angiogram demonstrates a left isolated internal iliac aneurysm. B, The main body of the IBE is deployed in the common iliac artery with embolization coils in the anterior division and the IBE limb extending into proximal portion of posterior division of hypogastric artery. C, Completion angiogram demonstrates flow through the posterior division and collateral perfusion to the buttock. No endoleak is seen. The red arrow shows the distal end of a Viabahn covered stent (W. L. Gore and Associates) at the takeoff of gluteal artery. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 37-40DOI: ( /j.jvscit ) Copyright © 2016 The Author(s) Terms and Conditions

4 Fig 3 A three-dimensional reconstruction of a computed tomography angiogram at the 1-month follow-up visit after elective repair of left hypogastric iliac artery aneurysm repair shows good positioning of grafts in the right and left iliac arteries. The branched device can be seen on the left side with inclusion of hypogastric and external iliac artery (red arrow). The patent gluteal artery on left side can also be seen as well (blue arrow). The GORE EXCLUDER (W. L. Gore and Associates, Flagstaff, Ariz) iliac limb (yellow arrow) is seen in the right common and external iliac artery. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 37-40DOI: ( /j.jvscit ) Copyright © 2016 The Author(s) Terms and Conditions

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