Cirugía Vascular y Endovascular
Renato A. Mertens:
Michel P. Bergoeing:
Leopoldo A. Mariné:
Albrecht H. Kramer:
Departamento de Cirugía Vascular y Endovascular, División de
Cirugía, Pontificia Universidad Católica de Chile, Santiago, Chile.
Ann Vasc Surg 2010; 24: 255.e9-255.e12
Annals of Vascular Surgery Inc.
Published online: November 9, 2009
Endografting has becomeamajor treatment option of abdominal aortic and iliac aneurysm.1 Anatomy is probably the major challenge to overcome to ensure safe and durable applicability of this technology. Iliac aneurysmal degeneration is commonly associated with aortic aneurysms. Commercially available devices can obtain a proper distal seal in dilated common iliac arteries up to 22 mm. When bilateral common iliac aneurysms are present, multiple options to deal with this situation have been described, including bilateral hypogastric occlusion associated with extension of the endograft into the external iliac arteries, accepting variable morbidity related to pelvic ischemia. Other alternatives, including unilateral hypogastric revascularization, have been described,2-8 but they all have limitations related to the technique itself, cost, or availability.