RESUMEN

Aneurysmal degeneration of distal landing zones after endovascular aneurysm repair (EVAR) can be a potential cause of late failure of this technique. Aneurysmal degeneration of common iliac arteries increases the risk of rupture of the iliac aneurysm itself as well as of the abdominal aortic aneurysm owing to aneurysm's reperfusion as a type Ib endoleak. Reoperation consists in plugging and covering the internal iliac artery (IIA), by extension into the external iliac artery, or preservation of antegrade flow in IIA by iliac branch devices (IBDs) or sandwich technique. The management of common iliac aneurysms after EVAR with the purpose of preserving antegrade flow into IIA generally requires a brachial or axillary access. However, this approach may be theoretically associated with local or systemic complications. We report a case of IBD implantation after EVAR, using a steerable sheath for IIA bridging stent deployment via contralateral femoral approach.

Asunto(s)

Aneurisma de la Aorta/cirugía , Implantación de Prótesis Vascular/instrumentación , Prótesis Vascular , Cateterismo Periférico/métodos , Procedimientos Endovasculares/instrumentación , Arteria Femoral , Aneurisma Ilíaco/cirugía , Stents , Dispositivos de Acceso Vascular , Anciano , Aortografía/métodos , Implantación de Prótesis Vascular/efectos adversos , Angiografía por Tomografía Computarizada , Procedimientos Endovasculares/efectos adversos , Arteria Femoral/diagnóstico por imagen , Humanos , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/etiología , Masculino , Diseño de Prótesis , Punciones , Recurrencia , Reoperación , Resultado del Tratamiento