Back Table Modification of Bifurcated Endurant Stent Graft to Aorto-Uni-Iliac Stent Graft to Treat Chronic Failure of Endovascular Abdominal Aortic Repair (EVAR) for Abdominal Aortic Aneurysm

Abstract

A patient who had previously undergone endovascular abdominal aortic repair (EVAR) of an abdominal aortic aneurysm was found to have aneurysmal growth 5 years after the initial EVAR and endovascular reintervention was considered. However, the patient was deemed unsuitable for an ordinary bifurcated stent graft. Re-EVAR was successfully conducted with a back table modification of the Endurant bifurcated stent graft to an aorto-uni-iliac (AUI) stent graft in a setting where a manufactured AUI stent graft was not available; this procedure was followed by a crossover femoro-femoral bypass. The patient's one-year follow-up exam revealed a marked regression of the aneurysm without any related complications. This modified technique may extend the limits of abdominal endovascular treatment for patients who are not suitable for a bifurcated stent graft and may be applicable in situations where adequate AUI devices are not available.