Single-Center Experience and 1-Year Follow-up Results of “Sandwich Technique” in the Management of Common Iliac Artery Aneurysms During EVAR

Abstract

In selected cases, the "sandwich technique" showed good outcomes confirming to be a safe and easy to perform way to overcome anatomical constraints and expanding the limits of EVAR.

Endovascular Chimney Technique for Juxtarenal Abdominal Aortic Aneurysm: A Systematic Review Using Pooled Analysis and Meta-Analysis

“…13 Avoiding multiple CGs and the presence of a short neck below the lowest CG might be beneficial to the successes of clinical treatment. 40 Important limitations exist in this retrospective study. One of the most obvious issues is that this is not a randomized or controlled trial with any comparisons.…”

“…This was a little higher compared with the 94% patency of CGs at 6 months in the report from Lee et al 14 The difference exited between these articles might be caused by the difference of SGs. 13,18,31,40,41 Donas et al 18 presented that the patencies of balloonexpandable and self-expanding chimney SGs in the treatment of pararenal aortic aneurysm were 97.8% and 100% at 6-month follow-up, respectively. In addition, the use of the more conformable aortic SGs might reduce the risks of gutters, and finally, reduce the morbidities.…”

Endovascular Repair of Aortoiliac Aneurysm Using Bifurcated Stent Grafts with Sandwich Technique for Preserving the Internal Iliac Artery

“…All reported technical access and excellent short-midterm outcomes have been without significant complications 12-15). Ricci et al16) demonstrated that the sandwich stent graft was still patent at the 1-year follow-up.…”

“…Moreover, the sandwich technique has a relatively lower cost than the custom made branched stent graft. There are also disadvantages of the sandwich technique: 1) it requires an access from the brachial artery in addition to the femoral arteries accesses; 2) Viabahn stent grafts are generally not much radiopaque so that positioning them requires extra experience; 3) the use of the Viabahn stent graft for the sandwich technique is limited by its available sizes (size range, 9-13 mm in diameter);16) 4) furthermore, a bailout technique needs to be developed for cases of perigraft leaks.…”

The Upside-Down Gore Excluder Limb and Double-Barrel Sandwich Technique for Penetrating Aortic Ulcer and Iliac Aneurysm Exclusion

“…The length of the overlapping zone is recommended to be at least 5 cm [ 8 ]. The suggested method for oversizing the two parallel grafts is that the summed areas of the two stent grafts should be 10%–30% more than the area of the more proximal graft [ 9 , 10 ]. In our patient, the area of the upside-down graft was about 201 cm 2 because we used the Excluder leg 16-mm proximal end in the upside-down configuration.…”