Novel Surgeon-Modified Fenestrated Iliac Stent Graft.

IF 1.7 2区 医学 Q3 PERIPHERAL VASCULAR DISEASE Journal of Endovascular Therapy Pub Date : 2025-04-01 Epub Date: 2023-05-16 DOI:10.1177/15266028231173311
Silvan Jungi, Dimitrios D Papazoglou, Hon-Lai Chan, Jürg Schmidli, Vladimir Makaloski
{"title":"Novel Surgeon-Modified Fenestrated Iliac Stent Graft.","authors":"Silvan Jungi, Dimitrios D Papazoglou, Hon-Lai Chan, Jürg Schmidli, Vladimir Makaloski","doi":"10.1177/15266028231173311","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>We describe the feasibility and early results of a novel endovascular approach with a surgeon-modified fenestrated iliac stent graft to preserve pelvic perfusion in patients with iliac aneurysms not suitable for iliac branch devices (IBDs).</p><p><strong>Technique: </strong>Seven high-risk patients, median age 76 years (range 63-83), with a complex aortoiliac anatomy with contraindications for commercially available IBDs were treated with a novel surgeon-modified fenestrated iliac stent graft between August 2020 and November 2021. The modified device was built using an iliac limb stent graft (Endurant II Stent Graft; Medtronic), which was partially deployed, surgically fenestrated with a scalpel, reinforced, re-sheathed, and inserted via femoral access. The internal iliac artery was cannulated and bridged with a covered stent. Technical success rate was 100%. After a median follow-up period of 10 months, there was 1 type II endoleak and no migrations, stent fractures, or loss of device integrity. One iliac limb occlusion occurred after 7 months, which needed a secondary endovascular intervention, restoring patency.</p><p><strong>Conclusion: </strong>Surgeon-modified fenestrated iliac stent graft is feasible and might be used as an alternative in patients with a complex iliac anatomy not suitable to commercially available IBDs. Long-term follow-up is needed to evaluate stent graft patency and potential complications.Clinical ImpactSurgeon modified fenetrated iliac stent grafts might be a promising alternative to iliac branch devices, extending endovascular solutions to a broader patient population with complex aorto-iliac anatomies preserving antegrade internal iliac artery perfusion. It is possible to treat small iliac bifurcations and large angulations of the iliac bifurcation safely and there is no need for a contralateral or upper-extremity access.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"342-349"},"PeriodicalIF":1.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Endovascular Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15266028231173311","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: We describe the feasibility and early results of a novel endovascular approach with a surgeon-modified fenestrated iliac stent graft to preserve pelvic perfusion in patients with iliac aneurysms not suitable for iliac branch devices (IBDs).

Technique: Seven high-risk patients, median age 76 years (range 63-83), with a complex aortoiliac anatomy with contraindications for commercially available IBDs were treated with a novel surgeon-modified fenestrated iliac stent graft between August 2020 and November 2021. The modified device was built using an iliac limb stent graft (Endurant II Stent Graft; Medtronic), which was partially deployed, surgically fenestrated with a scalpel, reinforced, re-sheathed, and inserted via femoral access. The internal iliac artery was cannulated and bridged with a covered stent. Technical success rate was 100%. After a median follow-up period of 10 months, there was 1 type II endoleak and no migrations, stent fractures, or loss of device integrity. One iliac limb occlusion occurred after 7 months, which needed a secondary endovascular intervention, restoring patency.

Conclusion: Surgeon-modified fenestrated iliac stent graft is feasible and might be used as an alternative in patients with a complex iliac anatomy not suitable to commercially available IBDs. Long-term follow-up is needed to evaluate stent graft patency and potential complications.Clinical ImpactSurgeon modified fenetrated iliac stent grafts might be a promising alternative to iliac branch devices, extending endovascular solutions to a broader patient population with complex aorto-iliac anatomies preserving antegrade internal iliac artery perfusion. It is possible to treat small iliac bifurcations and large angulations of the iliac bifurcation safely and there is no need for a contralateral or upper-extremity access.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
新型外科改良开窗髂骨支架。
目的:我们描述了一种新的血管内入路的可行性和早期结果,即外科改良的开窗髂支架移植,以保持不适合髂分支装置(ibd)的髂动脉瘤患者盆腔灌注。技术:在2020年8月至2021年11月期间,7名高危患者,中位年龄76岁(63-83岁),具有复杂的主动脉-髂解剖结构,并有市售ibd的禁忌症,接受了一种新型手术改良的开窗髂支架移植。该改良装置采用髂肢体支架(Endurant II stent graft;美敦力(Medtronic)),部分部署,手术开窗,用手术刀,加强,重新鞘,并通过股骨通道插入。髂内动脉插管,用覆盖支架桥接。技术成功率100%。中位随访10个月后,有1例II型内漏,无移位、支架骨折或器械完整性丧失。7个月后发生1例髂肢体闭塞,需要二次血管内介入,恢复通畅。结论:外科改良的开窗髂骨支架移植是可行的,可以作为一种替代方案,用于髂解剖结构复杂,不适合市售ibd的患者。需要长期随访来评估支架通畅和潜在的并发症。临床影响:外科医生改良的有孔髂支架移植可能是髂分支装置的一个有希望的替代方案,将血管内解决方案扩展到更广泛的患者群体,这些患者具有复杂的主动脉-髂解剖结构,保留了顺行髂内动脉灌注。可以安全地治疗小的髂分叉和大角度的髂分叉,不需要对侧或上肢通路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.30
自引率
15.40%
发文量
203
审稿时长
6-12 weeks
期刊介绍: The Journal of Endovascular Therapy (formerly the Journal of Endovascular Surgery) was established in 1994 as a forum for all physicians, scientists, and allied healthcare professionals who are engaged or interested in peripheral endovascular techniques and technology. An official publication of the International Society of Endovascular Specialists (ISEVS), the Journal of Endovascular Therapy publishes peer-reviewed articles of interest to clinicians and researchers in the field of peripheral endovascular interventions.
期刊最新文献
Effects of Iliac Tortuosity Index on Fenestrated Endovascular Aortic Aneurysm Repair for Pararenal and Thoracoabdominal Aortic Aneurysms. Pulsatile Changes of the Aortic Diameter May Be Irrelevant Regarding Endograft Sizing in Patients With Aortic Disease. The Association Between the D-dimer Level at 1 Year After EVAR and Sac Diameter Change in Patients With Persistent Type 2 Endoleak. Sex-Related Outcomes in Asymptomatic Patients Undergoing Carotid Artery Stenting. Novel Surgeon-Modified Fenestrated Iliac Stent Graft.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1