Antegrade Hypogastric Revascularization During Endovascular Aortoiliac Aneurysm Repair: An Alternative to Bilateral Embolization

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dc.contributor.authorMertens, Renato A.
dc.contributor.authorBergoeing, Michel P.
dc.contributor.authorMarine, Leopoldo A.
dc.contributor.authorValdes, Francisco
dc.contributor.authorKramer, Albrecht H.
dc.date.accessioned2024-01-10T13:45:56Z
dc.date.available2024-01-10T13:45:56Z
dc.date.issued2010
dc.description.abstractAnatomy has been the major challenge to overcome to increase safe and durable applicability of endografting for the treatment of abdominal aortic aneurysm. Bilateral iliac aneurysm preventing an appropriate distal landing zone for the endograft is a common condition and can be managed by (a) increasing the diameter of the endograft, with limitations in available sizes, (b) bilateral hypogastric embolization, accepting an increased morbidity, (c) the use of a branched device, increasing the cost and currently with limited availability, (d) combined surgical hypogastric revascularization by the retroperitoneal approach, or (e) retrograde revascularization from the ipsilateral external iliac artery using an endograft. We describe the use of widely available devices to obtain stable ante-grade revascularization of one hypogastric artery during aortic endografting. We report the case of a 68-year-old man, at high risk for an open procedure, who presented with bilateral iliac aneurysm and minor aortic ectasia; no iliac landing zone was available. A regular bifurcated graft was deployed and extended into one of the external iliac arteries, preceded by ipsilateral hypogastric embolization. Through an upper extremity approach, an endograft was deployed from the remaining bifurcated graft branch into the other hypogastric artery, followed by ipsilateral external iliac occlusion. Finally a femorofemoral crossover bypass was performed. The patient recovered event free, and patency of the endograft and absence of endoleak were demonstrated on computed tomography. Minor unilateral buttock claudication resolved in 6 weeks and sexual function was preserved. This technique is a reasonable alternative to consider in the endovascular treatment of patients with bilateral iliac aneurysm, allowing preservation of pelvic perfusion, limiting cost, and using available devices.
dc.fechaingreso.objetodigital20-03-2024
dc.format.extent4 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.avsg.2009.07.009
dc.identifier.eissn1615-5947
dc.identifier.issn0890-5096
dc.identifier.pubmedidMEDLINE:19900779
dc.identifier.urihttps://doi.org/10.1016/j.avsg.2009.07.009
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79098
dc.identifier.wosidWOS:000274080400020
dc.information.autorucMedicina;Bergoeing MP;S/I;92603
dc.information.autorucMedicina;Kramer AH;S/I;98256
dc.information.autorucMedicina;Marine L;S/I;4085
dc.information.autorucMedicina;Mertens R;S/I;75745
dc.issue.numero2
dc.language.isoen
dc.nota.accesocontenido parcial
dc.publisherELSEVIER SCIENCE INC
dc.revistaANNALS OF VASCULAR SURGERY
dc.rightsacceso restringido
dc.subjectABDOMINAL AORTIC-ANEURYSM
dc.subjectINTERNAL ILIAC ARTERY
dc.subjectFEMOROFEMORAL CROSSOVER
dc.subjectPELVIC CIRCULATION
dc.subjectBYPASS
dc.subjectEXPERIENCE
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAntegrade Hypogastric Revascularization During Endovascular Aortoiliac Aneurysm Repair: An Alternative to Bilateral Embolization
dc.typeartículo
dc.volumen24
sipa.codpersvinculados92603
sipa.codpersvinculados98256
sipa.codpersvinculados4085
sipa.codpersvinculados75745
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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