He serves as a consultant to medtronic and a scientific advisor to the trial evaluating the endurant bifurcated and aorto uni iliac stent graft systems. Posted in vascular disease management journal, vascular disease research tagged anatomic variation, aorto uni iliac stent, arteria lusoria, balloon angioplasty, carotid artery stenting, clearway rx, embolic protection device, endovascular aneurysm repair, endurant ii aui stent graft system, michel makaroun md, open aneurysm repair, original. Aorto aortic tube to cover the aorta 34704702 aorto uni iliac tube to cover the aorta and one common iliac artery 3470334704 aorto bi iliac tube to cover the aorta and both common iliac arteries 3470534706 ilio iliac tube to cover an iliac artery 3470734708. The new excluder iliac branch endoprosthesis gore is safe and effective at treating aortoiliac aneurysms and common iliac artery aneurysms, maintaining blood flow into the internal iliac artery, and preventing the complications associated with internal iliac artery sacrifice, darren schneider, new york, usa, told delegates at the vascular annual meeting 911 june, national harbor, usa. This blockage is typically caused by a buildup of plaque within. All devices underwent further refinements after initial release, improving both. May 14, 2015 when an aorto uni iliac aui device was necessary in 9 patients, endurant medtronic inc, santa rosa, ca, usa was used. Surgical bypass is not a cure for aortoiliac occlusive disease. The stent graft was composed of the bifurcated, limb, aorto uni iliac, aortic extension, and iliac extension components. Endurant bifurcated and aortouniiliac aui stent graft system. The options for dealing with aorto iliac disease include conservative medication and exercise, endovascular angioplasty or stenting, endarterectomy opening the damaged arteries, removing the blockages, and closing the artery cuts with patches, or bypass aorto femoral, aorto iliac, or axillofemoral. The remaining 110 patients had a unilateral iliac occlusion in 29 26. Aorto uni iliac endografts figure 1c attach proximally to the nonaneurysmal neck and distally to the iliac or femoral artery 10,11. Exclusion of an internal iliac artery aneurysm using stacked.
The iliac arteries go through your pelvis into your legs, where they divide into many smaller arteries that run down to your toes. The endurant stent graft system bifurcated device is administered to treat patients with an abdominal aortic aneurysm. Aortoiliac medical definition merriamwebster medical. The graft creates a path so that blood can move around the blockage. Listing a study does not mean it has been evaluated by the u. Delivery success successful vascular access and delivery of the device to. Tadros, md, facs, rpvi associate program director associate professor of surgery and radiology division of vascular surgery, department of surgery mount sinai medical center. An aorto mono iliac aneurysm with a challenging dsz consisting of an aneurysmatic and tortuous right common iliac artery a.
The indication for aui was unclear from case report forms in 18 registry cases. Endovascular repair of aortoiliac aneurysmal disease with the helical iliac bifurcation device and the bifurcatedbifurcated iliac bifurcation device. Aortoiliac disease is considered a type of peripheral arterial disease pad because it affects arteries, which are blood vessels that carry blood away from your heart to your limbs. Apr 02, 2017 the iliac limbs of some stent graft systems will have proximal flares and can be used in a telescoping manner to create an aorto uni iliac aui configuration in occlusive disease. All aortouniiliac devices were used primarily in these patients. Endovascular management of aorto iliac occlusive disease adjunct techniques in a complicated case. Aorto bi iliac grafts were used in 103 patients while 5 patients had aorto uni iliac device and a straight graft was applied in one patient. Aortoiliac occlusive disease is the blockage of the aorta, the main blood vessel in your body, or the iliac arteries. Medtronic is expanding its portfolio of products for endovascular aortic repair in the united states with two new medical devices.
The role of aortouniiliac devices in the treatment of. Implantation of iliac side branch devices is a feasible technique. The endurant ii stent graft system aortouniiliac aui stent graft is indicated for. What is aortoiliac and aortofemoral bypass graft surgery. We investigated the safety and efficacy of primary aortouniiliac aui endovascular aortic repair evar without femfem crossover in patients with abdominal aortic aneurysm aaa and concomitant aortoiliac occlusive disease. It is a treatment given to resolve the symptoms when medical management or minimally invasive therapies, such as balloon angioplasty and stenting, have not worked or are not suitable. To be used in conjunction with the gore excluder aaa endoprosthesis, this firstofitskind device is a complete system and has.
The contralateral common iliac artery is then occluded with an endovascularly placed device, and flow is restored with a conventional femoralfemoral bypass. Ct angiography cta 3 years postevar showing the successful exclusion of the aneurysm with a bifurcated endograft zenith supported with an iliac side branch device for the right common iliac artery b. Disclosure i have the following potential conlict of interests to report consultant. Iliac anatomy and the incidence of adjunctive maneuvers. All aorto uni iliac devices were used primarily in these patients.
Frequency table of patency categories for each of the 3 arterial segments aorto femoro tibio asymptotic patency iliac popliteal peroneal significance cateogies segment segment segment total level category 5 6 50 91 147. The endurant ii stent graft system aorto uni iliac aui stent graft is indicated for the endovascular treatment of infrarenal abdominal aortic or aortoiliac aneurysms in patients whose anatomy does not allow the use of a bifurcated stent graft. Aorto iliac bypass graft axillarybifemoral 2 3 and femoralfemoral bypass sometimes abbreviated axfem femfem. This document was downloaded for personal use only. A retrospective analysis of the data was done to identify all patients with aui devices implanted on an elective basis. Following inability to deploy a standard aorto uni iliac converter and subsequent iliac dissection, two lowprofile aorto uni iliac converters were deployed from the external to common iliac artery over a femorofemoral pullthrough wire, achieving a stacked configuration and successful aneurysm exclusion. Aortoiliac and aortofemoral bypass graft surgery overview in a bypass, artificial tubes grafts are placed near a section of the blood vessel that is blocked or narrowed. A mean followup period of 24 months was carried out. For more information or to schedule an appointment, please call 3104238000. Relative indications for aortouniiliac endograft configuration. Advertisements on this site do not constitute a guarantee or endorsement by the journal, association, or publisher of the quality or value of such product or of the claims made for it by its manufacturer. Aortoiliac definition of aortoiliac by the free dictionary. The use of the aortouniiliac device in the treatment of abdominal. Keywords used were abdominal aortic aneurysms aaa, endovascular aortic aneurysm repair evar, aortouniiliac, aortomonoiliac, stent graft, outcome analysis.
The cook renu converter has a 22mm tall sealing zone designed for deployment inside another stent graft and would conform poorly to this kind of neck as a primary. As both inflammatory aortitis and infected pseudoaneurysm present similarly, all patients with pseudoaneurysm of the aorto iliac vessels were given intravenous broadspectrum. The gore excluder iliac branch endoprosthesis ibe is the first and only commercially. The role of aortouniiliac devices in the treatment of aneurysmal. The iliac limbs of some stent graft systems will have proximal flares and can be used in a telescoping manner to create an aortouniiliac aui configuration in occlusive disease. The gore excluder iliac branch endoprosthesis, is the only offtheshelf, fda approved aortic branch device indicated for the endovascular treatment of common iliac artery aneurysms or aortoiliac aneurysms. As for the pseudoaneurysm of the iliac vessels, v12 stent grafts by atrium medical were used. Jun 26, 2008 endurant bifurcated and aorto uni iliac aui stent graft system the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Wednesday, may 11th 2016 from 07am to 09am gmt7 new york. Endovascular aneurysm repair with preservation of the internal iliac artery using the iliac branch graft device. Endovascular management of aortoiliac disease youtube. Endurant bifurcated and aortouniiliac aui stent graft. A prospective data record was kept for all patients. The device has been sold in europe for several years under the brand name endofit aorto uni iliac stent graft. Technical success for iliac adjunctive procedures was defined as successful introduction and deployment of a device without a type ib or iii endoleak or graft limb occlusion.
While endovascular aaa grafts are nothing new, this is another potentially exciting. Since the approval of endograft devices for use in the united states. The use of iliac side branch devices in patients with. Makaroun, md, discusses patient candidacy and optimal application of aui devices. Techniques of endovascular repair of aortoiliac aneurysms. Zenith renu aaa ancillary graft converter cook medical. Aortoiliac occlusive disease society for vascular surgery. Endovascular management of aortoiliac occlusive disease. Iliac branch device results show value of internal iliac. Medtronic receives fda approval for aortouniiliac endurant.
Karthikesalingam a, hinchliffe rj, holt pj, boyle jr, loftus im, thompson mm. The bifurcated component consists of a bifurcated polyester graft material incorporated with nitinol stents, with the transition stent being the last stent on the main body, just proximal of the bifurcation fig. Landing zone diameters are 20 mm proximal, common iliac artery and 10 mm distal, external iliac artery and therefore suitable for an aorto uni iliac converter with or without extensions as appropriate. Aortouniiliac stent grafts with and without crossover. Aortouniiliac stent grafting and femorofemoral bypass in a. Endovascular repair of abdominal aortic aneurysm uptodate. Summarized, implantation of iliac side branch devices is a feasible technique with favourable shortterm results in patients with aortoiliac aneurysm. The unifit aortauniiliac stent grafts patented construction permits usage in angulated anatomies with lowered risk of kinking or luminal constriction.
Surgical versus endovascular repair by iliac branch device of. Our objective was to present the results of the multicenter evtguidant aorto uni iliac trial and to compare them with the tube, bifurcated graft, and open control series in regard to patient. Company name product name main body extensions length cm main body extensions diameter mm iliac leg extensions length cm iliac leg extensions diameter mm aorto uni iliac converter length cm aorto uni iliac. An aortouniiliac aui graft with occlusion of the contralateral common. A surgical bypass reroutes blood flow around a diseased artery to increase blood flow to your legs. The zenith renu aaa ancillary graft with the ztrak introduction system is indicated for secondary endovascular intervention in patients having received prior endovascular repair of infrarenal abdominal aortic or aorto iliac aneurysms in which there is inadequate proximal fixation or seal.
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