The endurant stent graft system bifurcated device is administered to treat patients with an abdominal aortic aneurysm. Technical success for iliac adjunctive procedures was defined as successful introduction and deployment of a device without a type ib or iii endoleak or graft limb occlusion. Iliac anatomy and the incidence of adjunctive maneuvers. Iliac branch device results show value of internal iliac. A retrospective analysis of the data was done to identify all patients with aui devices implanted on an elective basis. The development of iliac branch devices has allowed incorporation of one or both internal iliac arteries using a total endovascular approach with modular stent grafts. This blockage is typically caused by a buildup of plaque within. Disclosure i have the following potential conlict of interests to report consultant.
Endovascular management of aortoiliac occlusive disease. What is aortoiliac and aortofemoral bypass graft surgery. Aorto iliac bypass graft axillarybifemoral 2 3 and femoralfemoral bypass sometimes abbreviated axfem femfem. Aortoiliac occlusive disease is the blockage of the aorta, the main blood vessel in your body, or the iliac arteries. He serves as a consultant to medtronic and a scientific advisor to the trial evaluating the endurant bifurcated and aorto uni iliac stent graft systems. The iliac arteries are the branches that your aorta divides into around the level of the belly button to provide blood to your legs and the organs in your pelvis. Listing a study does not mean it has been evaluated by the u. Company name product name main body extensions length cm main body extensions diameter mm iliac leg extensions length cm iliac leg extensions diameter mm aorto uni iliac converter length cm aorto uni iliac. As for the pseudoaneurysm of the iliac vessels, v12 stent grafts by atrium medical were used. Following inability to deploy a standard aorto uni iliac converter and subsequent iliac dissection, two lowprofile aorto uni iliac converters were deployed from the external to common iliac artery over a femorofemoral pullthrough wire, achieving a stacked configuration and successful aneurysm exclusion. Endovascular management of aortoiliac disease youtube. Endurant bifurcated and aortouniiliac aui stent graft system. Medtronic receives fda approval for aortouniiliac endurant.
Posted in vascular disease management journal, vascular disease research tagged anatomic variation, aorto uni iliac stent, arteria lusoria, balloon angioplasty, carotid artery stenting, clearway rx, embolic protection device, endovascular aneurysm repair, endurant ii aui stent graft system, michel makaroun md, open aneurysm repair, original. Apr 02, 2017 the iliac limbs of some stent graft systems will have proximal flares and can be used in a telescoping manner to create an aorto uni iliac aui configuration in occlusive disease. The remaining 110 patients had a unilateral iliac occlusion in 29 26. Surgical bypass is not a cure for aortoiliac occlusive disease. The indication for aui was unclear from case report forms in 18 registry cases. Surgical versus endovascular repair by iliac branch device of. Ct angiography cta 3 years postevar showing the successful exclusion of the aneurysm with a bifurcated endograft zenith supported with an iliac side branch device for the right common iliac artery b. Wednesday, may 11th 2016 from 04am to 06am gmt10 san francisco.
A mean followup period of 24 months was carried out. Summarized, implantation of iliac side branch devices is a feasible technique with favourable shortterm results in patients with aortoiliac aneurysm. The gore excluder iliac branch endoprosthesis ibe is the first and only commercially. A prospective data record was kept for all patients. For more information or to schedule an appointment, please call 3104238000.
Those who received a femfem crossover bypass were considered as the standard group group a. Aortoiliac occlusive disease society for vascular surgery. This document was downloaded for personal use only. An aorto mono iliac aneurysm with a challenging dsz consisting of an aneurysmatic and tortuous right common iliac artery a. The iliac limbs of some stent graft systems will have proximal flares and can be used in a telescoping manner to create an aortouniiliac aui configuration in occlusive disease.
Implantation of iliac side branch devices is a feasible technique. The cook renu converter has a 22mm tall sealing zone designed for deployment inside another stent graft and would conform poorly to this kind of neck as a primary. Our objective was to present the results of the multicenter evtguidant aorto uni iliac trial and to compare them with the tube, bifurcated graft, and open control series in regard to patient. A surgical bypass reroutes blood flow around a diseased artery to increase blood flow to your legs.
The unifit aortauniiliac stent grafts patented construction permits usage in angulated anatomies with lowered risk of kinking or luminal constriction. Aortoiliac and aortofemoral bypass graft surgery overview in a bypass, artificial tubes grafts are placed near a section of the blood vessel that is blocked or narrowed. The bifurcated component consists of a bifurcated polyester graft material incorporated with nitinol stents, with the transition stent being the last stent on the main body, just proximal of the bifurcation fig. The stent graft was composed of the bifurcated, limb, aorto uni iliac, aortic extension, and iliac extension components. All devices underwent further refinements after initial release, improving both. An aortouniiliac aui graft with occlusion of the contralateral common. All aortouniiliac devices were used primarily in these patients. The role of aortouniiliac devices in the treatment of aneurysmal. While endovascular aaa grafts are nothing new, this is another potentially exciting. The gore excluder iliac branch endoprosthesis, is the only offtheshelf, fda approved aortic branch device indicated for the endovascular treatment of common iliac artery aneurysms or aortoiliac aneurysms.
May 14, 2015 when an aorto uni iliac aui device was necessary in 9 patients, endurant medtronic inc, santa rosa, ca, usa was used. Exclusion of an internal iliac artery aneurysm using stacked. Endurant bifurcated and aortouniiliac aui stent graft. All aorto uni iliac devices were used primarily in these patients. Delivery success successful vascular access and delivery of the device to.
Tadros, md, facs, rpvi associate program director associate professor of surgery and radiology division of vascular surgery, department of surgery mount sinai medical center. Wednesday, may 11th 2016 from 07am to 09am gmt7 new york. The use of the aortouniiliac device in the treatment of abdominal. Medtronic is expanding its portfolio of products for endovascular aortic repair in the united states with two new medical devices. Endovascular management of aorto iliac occlusive disease adjunct techniques in a complicated case. Aorto aortic tube to cover the aorta 34704702 aorto uni iliac tube to cover the aorta and one common iliac artery 3470334704 aorto bi iliac tube to cover the aorta and both common iliac arteries 3470534706 ilio iliac tube to cover an iliac artery 3470734708. The endurant ii stent graft system aorto uni iliac aui stent graft is indicated for the endovascular treatment of infrarenal abdominal aortic or aortoiliac aneurysms in patients whose anatomy does not allow the use of a bifurcated stent graft. Keywords used were abdominal aortic aneurysms aaa, endovascular aortic aneurysm repair evar, aortouniiliac, aortomonoiliac, stent graft, outcome analysis. Frequency table of patency categories for each of the 3 arterial segments aorto femoro tibio asymptotic patency iliac popliteal peroneal significance cateogies segment segment segment total level category 5 6 50 91 147. Endovascular repair of abdominal aortic aneurysm uptodate. Makaroun, md, discusses patient candidacy and optimal application of aui devices. Aortouniiliac stent grafts with and without crossover. Relative indications for aortouniiliac endograft configuration. Aortouniiliac stent grafting and femorofemoral bypass in a.
Aortoiliac definition of aortoiliac by the free dictionary. The graft creates a path so that blood can move around the blockage. Since the approval of endograft devices for use in the united states. Jun 26, 2008 endurant bifurcated and aorto uni iliac aui stent graft system the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Aorto bi iliac grafts were used in 103 patients while 5 patients had aorto uni iliac device and a straight graft was applied in one patient. The contralateral common iliac artery is then occluded with an endovascularly placed device, and flow is restored with a conventional femoralfemoral bypass. Endovascular aneurysm repair with preservation of the internal iliac artery using the iliac branch graft device. The role of aortouniiliac devices in the treatment of. Techniques of endovascular repair of aortoiliac aneurysms. Aortoiliac medical definition merriamwebster medical. We investigated the safety and efficacy of primary aortouniiliac aui endovascular aortic repair evar without femfem crossover in patients with abdominal aortic aneurysm aaa and concomitant aortoiliac occlusive disease. The use of iliac side branch devices in patients with. An 85yearold male presented with a 7cm left iiaa causing hydronephrosis. The zenith renu aaa ancillary graft with the ztrak introduction system is indicated for secondary endovascular intervention in patients having received prior endovascular repair of infrarenal abdominal aortic or aorto iliac aneurysms in which there is inadequate proximal fixation or seal. The endurant ii stent graft system aortouniiliac aui stent graft is indicated for. Initial experience with the eliac iliac branch device for. Karthikesalingam a, hinchliffe rj, holt pj, boyle jr, loftus im, thompson mm.
Endovascular repair of aortoiliac aneurysmal disease with the helical iliac bifurcation device and the bifurcatedbifurcated iliac bifurcation device. Techniques of endovascular aortoiliac repair using an. The options for dealing with aorto iliac disease include conservative medication and exercise, endovascular angioplasty or stenting, endarterectomy opening the damaged arteries, removing the blockages, and closing the artery cuts with patches, or bypass aorto femoral, aorto iliac, or axillofemoral. It is a treatment given to resolve the symptoms when medical management or minimally invasive therapies, such as balloon angioplasty and stenting, have not worked or are not suitable. Zenith renu aaa ancillary graft converter cook medical.
While the present driver for the development of acute aortic programs is at the. The new excluder iliac branch endoprosthesis gore is safe and effective at treating aortoiliac aneurysms and common iliac artery aneurysms, maintaining blood flow into the internal iliac artery, and preventing the complications associated with internal iliac artery sacrifice, darren schneider, new york, usa, told delegates at the vascular annual meeting 911 june, national harbor, usa. As both inflammatory aortitis and infected pseudoaneurysm present similarly, all patients with pseudoaneurysm of the aorto iliac vessels were given intravenous broadspectrum. The iliac arteries go through your pelvis into your legs, where they divide into many smaller arteries that run down to your toes. The device has been sold in europe for several years under the brand name endofit aorto uni iliac stent graft. Landing zone diameters are 20 mm proximal, common iliac artery and 10 mm distal, external iliac artery and therefore suitable for an aorto uni iliac converter with or without extensions as appropriate. Aorto uni iliac endografts figure 1c attach proximally to the nonaneurysmal neck and distally to the iliac or femoral artery 10,11.
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