LAUSR

We report the use of manufacturer customized fenestrated iliac stent grafts to treat common iliac artery aneurysms in patients with challenging iliac anatomy, unsuitable for iliac branched devices IBDs. A 71-year-old woman presented with bilateral common iliac artery aneurysms [CIAA] measuring 44mm and 29mm and a peri-visceral abdominal aortic aneurysm [AAA]. The second patient, a 72-year old male had a 42mm CIAA and an AAA, which expanded to 50mm in short interval follow up. The contralateral internal iliac was occluded. Both patients were deemed high risk for open repair and endovascular repair was recommended. The aneurysm anatomies were unsuitable for isolated CIAA repair. Suitable sealing zones for endovascular repair were the visceral segment proximally and the external iliac arteries [EIA]. Preservation of both internal iliac arteries [IIA] was important to reduce the risk of spinal cord ischaemia [SCI] but due to distal CIA narrowing, neither patient had sufficient "space" for the branches used in conventional IBD deployment. Three fenestrated Vascutek AnacondaTM iliac limbs were successfully deployed. All three IIAs were preserved with no endoleak and the patients discharged after an uneventful post procedural course. To our knowledge, this is the first successful report of iliac aneurysm repair with manufacturer customized fenestrated iliac limbs.