1. Experience With Unfavorable Iliac Access When Performing Fenestrated/Branched Endovascular Aneurysm Repair
- Author
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Giada Sgorlon, Birgit Sweet, Stéphan Haulon, Adrien Hertault, Aurélia Bianchini, Teresa Martin-Gonzalez, Jonathan Sobocinski, Guillaume Daniel, and Dominique Fabre
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Vascular access ,Prosthesis Design ,Endovascular aneurysm repair ,Blood Vessel Prosthesis Implantation ,Aortic aneurysm ,medicine.artery ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,Retrospective Studies ,business.industry ,Endovascular Procedures ,medicine.disease ,Common iliac artery ,Blood Vessel Prosthesis ,Surgery ,Treatment Outcome ,Iliac artery occlusion ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal - Abstract
Purpose: To review a single-center experience with fenestrated and branched endovascular aneurysm repair (f/bEVAR) in patients with challenging iliac anatomies. Materials and Methods: A retrospective review of the department’s database identified 398 consecutive patients who underwent complex endovascular repair f/bEVAR between January 2010 and June 2018; of these, 67 had challenging accesses. The strategies implemented to overcome access issues were reviewed, using a dedicated scoring system to evaluate the access (integrating diameter, tortuosity, calcification, and previous open or endovascular repair). Results: In this subgroup of patients, the most common graft design was a 4-vessel fenestrated endograft (27, 40.3%). Hostile access was due to small diameter (Conclusion: Dedicated strategies can be implemented to overcome hostile iliac access in patients with complex aneurysms when f/bEVAR is required. Typically, these maneuvers are associated with favorable outcomes.
- Published
- 2021
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