Trapease vena cavel filter through Jugular approach – In Initial experience
An endovascular aneurysm (EVAR) repair of an aortic aneurysm extending to the iliac artery remains a challenge. Interventional occlusion of the internal iliac artery (IIA) intending to create a distal landing zone in the external iliac artery is a common approach with inherent morbidity (e.g., buttock claudication, impotence). Alternatively, iliac side-branched stent grafts can maintain pelvic blood supply, but the applicability is limited. The objective was to investigate the morphological applicability of the Cook Zenith branched graft (ZBIS) among patients with aortoiliac or isolated iliac aneurysms.
This was a retrospective single-centre analysis of 66 patients (60 men; median age 74 years, range 53-90 years) undergoing repair of aortoiliac aneurysms (open repair, IIA occlusion prior to EVAR and ZBIS) between January 2008 and December 2012. All available computed tomography angiograms with post-processing imaging were compared with the criteria for morphological applicability to (i) the manufacturer's instruction for use (IFU), and (ii) to criteria published in the literature, as well as (iii) to the institutional protocol.
In 66 patients, 88 targeted iliac aneurysms were studied. Of these, 36/88 (40.9%) were compliant with the manufacturer's IFU, 35/88 (39.8%) were compliant with the published criteria, and 51/88 (58.0%) were compliant with the in-house protocol. The most common morphological exclusion criterion was an aneurysmal IIA.
In the present cohort with an aorto-iliac aneurysm, a maximum of 58% could have been treated with an iliac side branch based on the current experience. In particular, an aneurysmal IIA seems to be a limiting factor for the use of the iliac side-branched stent graft.
Bali HK, Bhargava M, Banerjee S, Bhatta YK, Trapease vena cave filter through Jugular approach – In Initial experience. ISHR abstract 2001: P-111.