Results of a double-barrel technique with commercially available devices for hypogastric preservation during aortoilac endovascular abdominal aortic aneurysm repair

Abstract

The double-barrel technique for hypogastric preservation is technically feasible across multiple interventionalists using commercially available endografts without device modification. These procedures are associated with minimal morbidity, acceptable short-term limb-patency rates, and reduced buttock claudication compared with those involving contralateral hypogastric embolization.

Results of Repair of Iliac Artery Aneurysms with the Sandwich Technique

“…A combined series of 23 sandwich technique procedures in 22 patients at 2 institutions has been reported ( 23 ). Th e mean operative time, fl uoroscopy time, estimated blood loss, contrast use, length of stay, and patency rates of 95% for the EIA limb and 88% for the IIA limb were similar to our fi ndings.…”

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“…Hybrid procedures with surgical bypass or transposition have been substantially abandoned in the last decade, in favour of a total endovascular approach. [3,5,6,[8][9][10][11][14][15][16] Different off-label endoluminal techniques using commercially available devices have been proposed, among which the most relevant is the "double-barrel" intervention first described by Lobato. [13] In our series, we treated 3 patients with this procedure, with an immediate technical success in hypogastric preservation of 100% and a HA patency in the follow-up of 67% (2 out of 3).…”

“…[2,3,6,7] Several solutions exist for hypogastric flow preservation, such as the bell-bottom technique, hypogastric transposition/bypass, the "double barrel" technique, and the use of dedicated branched endografts, each laden with increasing complexity and/or financial burden. [3,6,[8][9][10][11][12][13][14][15][16] The present study evaluated the rationale of HA preservation in this clinical setting.…”

Reconstruction of the internal iliac artery in patients with aneurysmal disease: Two case reports

“…The interruption of the pelvic circulation may result in buttock ischemia, spinal cord, bowel and bladder ischemia, as well as erectile dysfunction (7). For this reason, novel endovascular approaches have recently been investigated, including the double-barrel technique (4) or the use of IBDs (5). …”

“…Endovascular options include the double-barrel technique (4) or the use of iliac branch devices (IBDs) (5). External-to-internal iliac artery bypass is a reasonable option for an open approach to preserve pelvic circulation (6).…”