Endovascular Aortoiliac Aneurysm Repair with Fenestrated Stent Graft and Iliac Side Branch Using Image Fusion without Iodinated Contrast Medium

Ann Vasc Surg. 2016 May:33:231.e5-9. doi: 10.1016/j.avsg.2015.11.031. Epub 2016 Mar 8.

Abstract

Background: The endovascular aneurysm repair (EVAR) is becoming the preferred method to treat an aortic aneurysm with its better short-term postoperative mortality and morbidity rates in comparison with the open repair. A main drawback of this method is the need to use a nephrotoxic iodinated contrast medium to visualize the aorta and its side branches.

Case report: An 83-year-old man with an asymptomatic infrarenal aortic aneurysm of a 51-mm diameter accompanied by a 42-mm aneurysm of the left common iliac artery was treated with combined fenestrated EVAR (FEVAR) and iliac side branch stent graft (ISBG) under guidance of image fusion (IF) without the intraoperative use of iodinated contrast agent.

Conclusions: Complex EVAR (FEVAR and ISBG) using computed tomography angiography IF is feasible and together with the use of CO2 angiography may help to abstain from need to nephrotoxic contrast medium.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / surgery*
  • Aortography
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Carbon Dioxide / administration & dosage*
  • Computed Tomography Angiography
  • Contrast Media / administration & dosage*
  • Endovascular Procedures / instrumentation*
  • Humans
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / surgery*
  • Male
  • Multimodal Imaging / methods*
  • Predictive Value of Tests
  • Prosthesis Design
  • Radiographic Image Interpretation, Computer-Assisted
  • Stents*
  • Treatment Outcome
  • Ultrasonography

Substances

  • Contrast Media
  • Carbon Dioxide