External-to-Internal Iliac Artery Endografting for the Exclusion of Iliac Artery Aneurysms:An Alternative Technique for Preservation of Pelvic Flow?

Purpose: The purpose of this study was to describe an alternative endovascular procedure to exclude iliac artery aneurysms, preserving perfusion to the internal iliac artery. Cases: Two patients, considered unfit for open repair, underwent endovascular repair of iliac artery aneurysms. One of these occurred after previous placement of a bifurcated prosthesis. In both cases the aneurysms were excluded using a nitinol stent covered with expanded polytetrafluoroethylene from the external to the internal iliac artery. Using this technique, the internal iliac arteries were perfused in a retrograde manner. Both interventions were technically successful. The external-to-internal endograft remained patent after 6 and 16 months, respectively. Conclusion: Endovascular placement of a stent-graft from the external iliac artery into the internal iliac artery may offer an alternative and minimal invasive alternative for the management of common and internal iliac artery aneurysms. With the use of this technique, pelvic perfusion is preserved. Further studies are warranted to appraise the advantages and risk of this approach for iliac artery aneurysms. (C) 2009 Wiley-Liss, Inc.