Emergent conversion of the Ovation Stent Graft System to aortouniiliac modification via occlusion of a unilateral internal iliac artery with a stentgraft as a bailout solution

Purpose To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice...

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Bibliographic Details
Published in:Vascular 2015-08, Vol.23 (4), p.440-443
Main Authors: Georgakarakos, Efstratios, Schoretsanitis, Nikolaos, Souftas, Vasileios D, Argyriou, Chris, Moustafa, Erchan, Georgiadis, George S, Lazarides, Miltos K
Format: Article
Language:English
Subjects:
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnosis
Aortic Aneurysm, Abdominal - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Emergencies
Endovascular Procedures - adverse effects
Endovascular Procedures - instrumentation
Graft Occlusion, Vascular - diagnosis
Graft Occlusion, Vascular - etiology
Graft Occlusion, Vascular - surgery
Humans
Iliac Artery - surgery
Ligation
Male
Prosthesis Design
Prosthesis Failure
Reoperation
Stents
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Purpose To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice of the internal iliac artery (IIA). Technique description Despite the repeated efforts from the femoral and brachial site, the collapsed/occluded contralateral limb gate could not be catheterized. In order to exclude successfully the orifice of the IIA, an oversized stentgraft was placed immediately at the common-to-external iliac artery (CIA-EIA) transition followed by peripheral ligation of the latter. The procedure was completed with crossover femorofemoral bypass. Conclusion Occlusion the IIA orifice with an oversized stentgraft in the CIA-EIA transition can be considered as a safe, simple, fast, and efficient bailout maneuver, followed by EIA ligation and crossover bypass.
ISSN:1708-5381
1708-539X
DOI:10.1177/1708538115585072