PMC10336784_01
Pre-operative contrast enhanced computed tomography.
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Contrast enhanced computed tomography (CT) showed an infrarenal AAA with a maximum infrarenal diameter of 70 mm and CIA aneurysms 32 mm on the right and 30 mm on the left with a 5 mm inferior mesenteric artery (IMA) (Fig. 1).
(A) The proximal side of the right iliac branched component deviates to cover the left CIA origin following a pull through wire procedure, resulting in complete CIA occlusion. (B) The tip of the 12 Fr Dryseal dilator is used to push the iliac branched component to create a gap.
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The proximal end of the right proximal iliac branched component deviated to cover the left CIA origin following a pull through wire procedure, resulting in complete left CIA occlusion (Fig. 2A). Fr Dryseal was inserted with a dilator in the 16 Fr Dryseal from the left side and a guidewire from the side of the 12 Fr Dryseal. Following this, the tip of the 12 Fr Dryseal dilator was used to push the iliac branched component to create a gap through which the guidewire passed successfully (Fig. 2B).
(A) Post-operative contrast enhanced computed tomography. (B-D) Computed tomography images show no endoleaks and a significant reduction in the diameter of the aneurysm over time. These were at five days (B), six months (C), and 12 months (D) after surgery.
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CT on a post-operative day five showed no endoleaks and a maximum infrarenal diameter of 70 mm, 50 mm at six months, and 40 mm at 12 months post-operatively, indicating a decrease in aortic sac diameter over time (Fig. 3).