PMC2897233_01
CT angiogram demonstrating 5.3 cm AAA without evidence of rupture or leak.
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F1
A CT angiogram was performed, which revealed the aneurysm to have grown to 5.3 cm without evidence of rupture (Fig. 1).
Coronal reconstructions from CT angiogram demonstrating right common iliac artery occlusion and severe left common iliac artery calcified stenoses.
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F2
Additionally, the left common iliac artery was noted to contain extensive calcified vascular disease (Fig. 2).
Calibrated angiogram showing severe stenosis of the left external iliac artery, measuring 4.5 mm at it narrowest point.
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F3
The left external iliac artery was severely stenosed, measuring 4.5 mm at its narrowest point (Fig. 3).
After controlled rupture of the left external iliac artery, an 18 French delivery system of the Zenith stent graft was easily accommodated.
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F4
With the left external iliac artery now dilated to 8 mm, we were able to insert a Zenith (Cook Medical) 22 x 133 mm aortouni iliac stent graft mounted on an 18 French delivery system with an extension into the common iliac artery with a 10 x 71 mm limb extender (Fig. 4).
Completion angiogram showing no evidence of endoleak. An aortouni iliac device is in place as well as the Viabahn Endoprosthesis in the left external iliac artery.
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F5
A completion angiogram revealed no evidence of endoleak (Fig. 5).
A, B Follow up CT angiogram at 6 months showing no evidence of endoleak, continued patency of the femorale-femoral crossover bypass graft, and patency of the Viabahn Endoprosthesis in the left external iliac artery.
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F6
On 1 and 6 month follow up, a CT angiogram was per formed, which demonstrated no evidence of endoleak, continued patency of the endoconduit in the left external iliac artery, continued patency of the left hypogastric artery, and retrograde perfusion of the right hypogastric artery (Fig. 6A, B).