Endovascular Treatment of an Iliac Artery Aneurysm U lizing the Snorkel Technique PDF
Preview Endovascular Treatment of an Iliac Artery Aneurysm U lizing the Snorkel Technique
Endovascular Treatment of an Iliac Artery Aneurysm U7lizing the Snorkel Technique: A modified approach LUIS VIRGEN MD PhD Cardiovascular Research Institute Director Guadalajara, Jalisco. México Valuntary Faculty, University of Miami. USA www.cardiovascular.mx [email protected] Incidence of Iliac Artery Aneurysms • 75-‐95% present with AAA • 0.03% life9me incidence • 0.3-‐1.9% of arterial aneurysms • 7th-‐8th decade of life • 8-‐9:1 male:female ra9o • Common Iliac Artery -‐ 70% • Internal Iliac Artery -‐ 20% • External Iliac Artery -‐ 10% • Bilateral Disease – 20-‐60% • Keep in mind that 25% of pa9ents with an AAA also have aneurysms of the Iliac Arteries. POSSIBLE ENDOVASCULAR TREATMENTS o EMBOLIZACION AND STENT GRAFT o ILIAC BRANCH DEVICE o SANDWICH-‐SNORKEL TECHNIQUE The emboliza9on op9on could lead to serious problem ILIAC BRANCHE DEVICE CONTRAINDICACIONES q NO STENOSIS q NO ANEURISMATIC IIA q NO KINKING q LANDING ZONE10 MM NO For these reasons this technique is not possible for every pa9ent . Only 38-‐55% are candidates We think if we change braquial acces, using contraleteral acces, in the lobato tecnique will be easer and beaer. YOU HAVE A NEW APPROACH? YES, I HAVE A SNORKEL- SANDWICH ME TOO, BUT WITH ANATOMICAL FIXATION… BRAQUIAL CONTRALATERAL ACCES ACCES Bifurcated Stent Grab, followed by Place a covered self expanding Cateteriza9on of the ipsilateral stent 2 cm inside iliac internal internel iliac artery throug a leb artery with 6 cm overlapping brachial acces Posi9oning of and iliac limb extension 1 cm below covered stent. First deploy the iliac limb extension and then the covered stent Endovascular Aor9c Stent Grab-‐EVAR with Anatomical Fixa9on Endologix CONTRALATERAL ACCES 5 fr Cateter t a Internal Iliac e h S Artery n ® g i rs ee vD O l a & r e p t Ua l a n r kint alo Hydrophilic BC Wire Guide &Amplatz super stiff 1 cm COURTESY DR. ALEJANDRO FABIANI
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