PMC6033046_01
PMC6033046_02
Pre-operative computed tomography angiography scans of (A) patient A and (B) patient B, demonstrating an isolated common iliac artery aneurysm (asterisk) with a proximal neck length (arrow) of >=20 mm and a neck diameter of <=22 mm.
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Fig. 1 (A, B). For both patients an isolated CIAA with a proximal neck length of >=20 mm (patient A: 26 mm; patient B: 24 mm) and a neck diameter of <=20 mm (patient A: 16.4 mm; patient B: 15.6 mm) was found.
Aortic BeGraft deployment in patient A. (A) Intra-operative fluoroscopy image demonstrating the positioning of the unexpanded aortic BeGraft in the proximal part of the IBD, (B) the dilatation of the balloon expandable covered stent graft (BeGraft, Bentley, Hechingen, Germany) to 12 mm inside the iliac branch device (Zenith Iliac Bifurcation, Cook Medical, Bloomington, IN, USA), followed by (C) inflation of the larger high pressure semi-compliant balloon (Cristal Balloon, Balt, Montmorency, France) in the proximal end of the BeGraft to obtain adequate sealing in the proximal CIA.
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The BeGraft was introduced through the ipsilateral common femoral artery and positioned proximally in the CIA (Fig. 2A). First, the aortic BeGraft was dilated to a diameter of 12 mm with the standard BeGraft balloon, which achieves adequate sealing in the body of the bifurcated graft (Fig. 2B). At this point, the balloon was exchanged for a larger high pressure semi-compliant balloon (Cristal Balloon, Balt, Montmorency, France) that was used to dilate the proximal part of the BeGraft outside the IBD to obtain adequate sealing in the proximal CIA (Fig. 2C).
Computed tomography angiography scan at 1 month follow up demonstrating patent iliac arteries and no endoleak, migration, or other complications for (A) patient A and (B) patient B.
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Follow up imaging 1 month post-operatively demonstrated patent iliac arteries and no endoleak, migration, or other complications in both patients (Fig. 3A and B).