Steerable sheath for exclusively femoral bilateral extension of previous fenestrated endovascular aneurysm repair with iliac branch devices

• Main Authors: Roberta Vaccarino, MD, Angelos Karelis, MD, Björn Sonesson, MD, PhD, Nuno V. Dias, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2021-06-01
• Series: Journal of Vascular Surgery Cases and Innovative Techniques
• Subjects: Endovascular aneurysm repair; Branched stent graft; Contralateral approach; Femoral access; Iliac branch device
• Online Access: http://www.sciencedirect.com/science/article/pii/S2468428721000629

We report the treatment of type Ib endoleak after fenestrated endovascular aneurysm repair (FEVAR) with iliac branch device (IBD) to allow exclusive transfemoral access without a femoral-to-femoral through-and-through wire. The patient was treated with fenestrated endovascular aneurysm repair and showed expansion of the aneurysm owing to a type Ib endoleak. An IBD was implanted by the use of a contralateral steerable sheath for internal iliac artery catheterizing. A computed tomography scan showed the patency of the target vessels and resolution of the endoleak. The use of a steerable sheath without femoral-to-femoral through-and-through wire to bridge the internal iliac artery in patients receiving an IBD after prior EVAR is feasible and avoids the risks associated with upper extremity access.