# 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.

## Key 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.