Steerable sheath for exclusively femoral bilateral extension of previous fenestrated endovascular aneurysm repair with iliac branch devices

Roberta Vaccarino; Angelos Karelis; Björn Sonesson; Nuno V Dias

doi:10.1016/j.jvscit.2021.04.002

Steerable sheath for exclusively femoral bilateral extension of previous fenestrated endovascular aneurysm repair with iliac branch devices

J Vasc Surg Cases Innov Tech. 2021 Apr 24;7(2):322-325. doi: 10.1016/j.jvscit.2021.04.002. eCollection 2021 Jun.

Authors

Roberta Vaccarino¹, Angelos Karelis¹, Björn Sonesson¹, Nuno V Dias¹

Affiliation

¹ Vascular Center Malmö, Department of Thoracic surgery and vascular diseases, Skåne University Hospital, Malmö, Sweden.

Abstract

We report the treatment of type Ib endoleak after fenestrated endovascular aneurysm repair (FEVAR) with iliac branch device (IBD) to allow exclusive transfemoral access without a femoral-to-femoral through-and-through wire. The patient was treated with fenestrated endovascular aneurysm repair and showed expansion of the aneurysm owing to a type Ib endoleak. An IBD was implanted by the use of a contralateral steerable sheath for internal iliac artery catheterizing. A computed tomography scan showed the patency of the target vessels and resolution of the endoleak. The use of a steerable sheath without femoral-to-femoral through-and-through wire to bridge the internal iliac artery in patients receiving an IBD after prior EVAR is feasible and avoids the risks associated with upper extremity access.

Keywords: Branched stent graft; Contralateral approach; Endovascular aneurysm repair; Femoral access; Iliac branch device.