2024 Volume 33 Issue 6 Pages 355-360
In cases of iliac artery aneurysm, the stent graft limb, a component of the endovascular aneurysm repair device, can be used individually for endovascular treatment (EVT). In cases where the proximal landing zone diameter exceeds that of the limb, an upside-down limb implantation is necessary. This is because the proximal diameter is generally uniform for each device. In the presented case, EVT was successfully performed using an upside-down Ovation iX iliac limb for a left internal iliac artery aneurysm. The Ovation iX iliac limb has a sinusoidal stent, is more flexible than the Excluder limb, which has a similar structure, and may be useful for EVT in the iliac artery region considering patency and conformability. The limb was deployed within a sheath (Check-Flo) extracorporeally by inserting it from the sheath’s front side first. Subsequently, the limb was introduced into the artery by inserting it into another sheath (DrySeal), which had been placed previously, and pushed up with the modified terminal end of the inner sheath. For deployment, the outer sheath was pulled while providing support to the limb using the terminal end of the inner sheath. This technique may broaden the surgical indications and strategies for iliac artery aneurysms.
