Reversal Of A Gore Excluder Limb To Obtain Proximal Seal During Repair Of A Ruptured Hypogastric Artery Aneurysm
Andy Peshkepija, MD, Kevin T. Onofrey, Abdul K. Natour, MD, Loay Kabbani, MD, Omar Kafri, BS.
Henry Ford Hosptial, Detroit, MI, USA.
Hypogastric artery aneurysms (HAA) are rare accounting for only 2% of patients with aorto-iliac aneurysmal disease. Endovascular treatment of Rupture HAA (R-HAA) relies on achieving proximal and distal seal. Appropriate seal proximally may be hindered by the size of the iliac arteries. This video demonstrates our step-by step technique for successful endovascular repair of a R-HAA when the proximal common iliac landing zone diameter was larger than any available covered stent. Proximal seal was achieved using reverse deployment of a Gore excluder endo-prosthesis (W. L. Gore & Associates, Flagstaff, Ariz). In addition to discussing the case, we demonstrate the ex vivo technique to dismantle, reload and deploy an iliac limb Gore endo-prosthesis in a reversed fashion.
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