Clinical Study of a Physician Modified Y-Type Iliac Branch Device (PMYIBD) in the Endovascular Repair of Abdominal Aortic Aneurysms to Preserve the Internal Iliac Artery

Zihe Zhao; Yi Jin; Dongsheng Fu; Chen Liu; Tong Qiao; Xiaoqiang Li; Xia Gao; Zhao Liu

doi:10.1177/15266028231165185

Clinical Study of a Physician Modified Y-Type Iliac Branch Device (PMYIBD) in the Endovascular Repair of Abdominal Aortic Aneurysms to Preserve the Internal Iliac Artery

J Endovasc Ther. 2023 Apr 17:15266028231165185. doi: 10.1177/15266028231165185. Online ahead of print.

Authors

Zihe Zhao^{1

2}, Yi Jin¹, Dongsheng Fu¹, Chen Liu¹, Tong Qiao¹, Xiaoqiang Li¹, Xia Gao², Zhao Liu¹

Affiliations

¹ Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
² Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China.

PMID: 37066784
DOI: 10.1177/15266028231165185

Abstract

Objectives: To report the method and curative effect of using a physician modified Y-type iliac branch device (PMYIBD) to preserve the internal iliac artery during the endovascular repair of abdominal aortic aneurysms.

Methods: From September 2018 to April 2022, 24 patients with abdominal aortic aneurysms or dissecting aneurysms, including 19 true aneurysms and 5 dissecting aneurysms involving the common iliac artery were treated in our department. The average age was (65.3 ± 7.6) years. All patients underwent preoperative evaluation by enhanced computed tomography. Combined with intraoperative angiography, a Y-type stent graft was prepared during surgery to perform endovascular repair of abdominal aortic aneurysms.

Results: All operations were successfully completed. The average operative duration was (224.8 ± 44.1) minutes. A total of 24 internal iliac arteries were reconstructed. The average follow-up time was (27.1 ± 13.5) months. During the follow-up, there was no expansion of aneurysm cavity, no endoleak or stent displacement, and no death occurred in all patients.

Discussion: The physician-modified Y-type iliac branched device (PMYIBD) provides an effective method for full-cavity repair. It has a wide range of indications and convenience. According to follow-up results, the early and mid-term had good curative effects; however, the long-term effects require further follow-up.

Conclusion: The modified Y-type IBD technique is safe and effective for aortic diseases involving internal iliac artery especially with complex anatomy.

Clinical impact: It is meaningful to preserve the IIA during EVAR. The use of PMYIBD provides a simple and effective method for the total endovascular repair of aortic diseases involving the IIA. Several advantages such as minimal trauma, low mortality, low complication rates and perfect short- and medium-term effects emerge in clinical practice. PMYIBDs are good choices for clinicians before suitable commercial stents are available in markets.

Keywords: abdominal aortic dissection; abdominal artery aneurysm; branch devices; internal iliac artery.