The Gore iliac branch endoprosthesis (IBE) enables internal iliac artery (IIA) reconstruction, extending the indications of endovascular aneurysmal repair (EVAR); however, the up-and-over technique is challenging. This study aimed to clarify the advantages and procedural limitations of the up-and-over technique. From January 2019 to October 2022, 22 patients who underwent IIA reconstruction with Gore IBE were enrolled. The patients were divided into the S and Up groups that underwent IIA reconstruction using the standard and up-and-over techniques, respectively. Aortic anatomic measurements, surgical factors, and postoperative outcomes were examined. No significant differences in operative time, fluoroscopy time, contrast medium use, blood loss volume, and length of postoperative hospital stay were observed between the S (12 patients) and Up (10 patients) groups. However, the distance from the lower renal artery to the reconstructed IIA origin was considerably shorter in the Up group than in the S group. During the 19-month follow-up, no adverse events were observed in the Up group. The up-and-over technique can be a valuable option for cases where IIA reconstruction is difficult with standard procedures with Gore IBE. Therefore, understanding the procedural precautions and ensuring safety are crucial to its success.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885932 | PMC |
| http://dx.doi.org/10.3400/avd.oa.24-00114 | DOI Listing |
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