Preservation of Blood Flow to the Internal Iliac Artery Using a Custom-Made Single Fenestrated Endograft: A Case Report

TL;DR

A custom-made endograft was used to preserve blood flow to the internal iliac artery in a patient with an unsuitable anatomy for standard treatment.

Contribution

The use of a custom single-fenestrated endograft is presented as a novel solution for preserving IIA flow in anatomically challenging cases.

Findings

A custom-made Terumo endograft successfully preserved blood flow to the right internal iliac artery.

This approach may prevent complications like buttock claudication and erectile dysfunction in unsuitable anatomy cases.

Abstract

This report describes the use of a custom-made single-fenestrated endograft to preserve blood flow to the internal iliac artery (IIA) in a patient with an aorto-iliac aneurysm with unsuitable anatomy for a standard iliac branch device (IBD).

A 56-year-old man presented with an abdominal aortic aneurysm (AAA) of 56 mm involving the right common iliac artery (CIA). Use of a standard IBD for preservation of the IIA was deemed impossible due to narrow arrow anatomy of the right CIA. To preserve IIA flow, a custom-made Terumo endograft with an additional single-fenestration for the IIA was designed. The repair was successful and flow to the right IIA was preserved.

Using a custom-made single-fenestrated endograft for the IIA in case of unsuitable anatomy for off-the-shelf IBDs prevents exclusion of the IIA and might prevent complications like buttock claudication and erectile dysfunction in patients with an aorto-iliac aneurysm. This report describes the use of a custom-made single fenestrated endograft to preserve blood flow to the IIA as a valuable alternative to standard iliac branched repair in patients with anatomical challenges.

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