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Endovascular repair of aortoiliac aneurysm with a hybrid technique to preserve pelvic perfusion

中华医学杂志(英文版) 2011年第23期124卷 4105-4108页

作者： WU Wei-wei JIANG Xue-ying LIU Bao CHEN Yu LIU Chang-wei Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Science Beijing 100032China Department of Anesthesiology Beijing Tongren Hospital Capital Medical University Beijing 100005 China

Endovascular aneurysm repair(EVAR) has been proven to be an effective and safe technique for abdominal or iliac artery ***,for aneurysms extending to both iliac bifurcations,routine EVAR will occlude both internal iliac arteries(IIAs),which may increase the risk for pelvic *** endovascular techniques have been developed to preserve the pelvic perfusion in EVAR for such *** article reports an endovascular repair of an aortoiliac aneurysm with an external iliac artery(EIA) to the IIA endograft to preserve the pelvic ***,an endograft was advanced into the left IIA under the help of an inflated aortic *** were deployed to embolize the distal type-1 endoleak from the tunnel around the *** an aortouniiliac endograft and an iliac extension were deployed below the renal arteries extending to the right ***,a right-to-left femoro-femoral artery bypass was constructed. Angiography at completion and computed tomography after 6 months demonstrated patency of all grafts and complete exclusion of the aneurysm without any *** repair with an ElA-to-IIA endograft to preserve the pelvic inflow is a feasible and effective technique for aortoiliac *** embolization might be an option to repair the distal type of *** balloon assisted U-turn technique may help advance the endovascular device over a sharp-angled vessel bifurcation.

关键词： abdominal aortic aneurysm internal iliac artery endovascular repair hybrid technique pelvic perfusion

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A new concept and classification of corona mortis and its clinical significance

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中华创伤杂志(英文版) 2016年第5期19卷 251-254页

作者： Talalwah Waseem Al King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences College of Medicine Department of Basic Medical SciencesHospital-NGHA Riyadh 11481 Saudi Arabia.

Purpose: The obturator artery and its accessory (aberrant) arising from different origins and crossing the pubic rami are vascular variations. The internal iliac artery usually provides the obturator artery which may communicates with the external iliac artery through either the accessory obturator or inferior epigastric artery. A collateral circulation between the external and internal iliac system is known as corona mortis. The aim of current study is to provide sufficient data of vascular variability crossing the pubic rami for clinical field. Methods: Present study includes 208 hemipelvises dissected in the Institution of Anatomy, Medical University of Graz. During dissection, the obturator artery and its accessory crossing the superior rami of pubic bone were found to have different origins. Results: The obturator artery arising from the external iliac artery and from the femoral artery accounts for 9.8% and 1.1% respectively. Therefore, it passes over the superior pubic rami in 10.9%. Further, the accessory (aberrant) artery arises only from the femoral artery in 1.1%. In present study, the vascular variation crossing the superior pubic rami with or without collateral circulation between external and internal iliac system referred as corona mortis is addressed. This study includes new classification of obturator and accessory obturator arteries as well as the corona mortis. It includes a comparison of corona mortis incidence in Austria population and other populations. The corona mortis found to be in 12% of Austrian population. Conclusion: A great attention of clinicians, radiologists, surgeons, orthopedic surgeons, obstetricians and gynecologists has to be considered before pubic surgical procedures such as internal fixation of pubic fracture, an inguinal hernia repair. Further, traumatic pubic rami fracture may lead to massive hemorrhage due to laceration

关键词： Obturator artery Accessory obturator artery internal iliac artery Hernia, inguinal Hernia, femoral

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Endovascular repair of aortoiliac aneurysm with a hybrid ：echnique to preserve pelvic perfusion

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Chinese Medical Journal 2011年第23期 4105-4108页

作者： WU Wei-wei JIANG Xue-ying LIU Bao CHEN Yu LIU Chang-wei Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Science Beijing 100032 China

Endovascular aneurysm repair （EVAR） has been proven to be an effective and safe technique for abdominal or iliac artery aneurysm. However, for aneurysms extending to both iliac bifurcations, routine EVAR will occlude both internal iliac arteries （llAs）, which may increase the risk for pelvic ischemia. New endovascular techniques have been developed to preserve the pelvic perfusion in EVAR for such situation. This article reports an endovascular repair of an aortoiliac aneurysm with an external iliac artery （EIA） to the IIA endograft to preserve the pelvic perfusion. First, an endograft was advanced into the left IIA under the help of an inflated aortic balloon. Coils were deployed to embolize the distal type-1 endoleak from the tunnel around the endograft, and an aortouniiliac endograft and an iliac extension were deployed below the renal arteries extending to the right EIA. Finally, a right-to-left femoro-femoral artery bypass was constructed. Angiography at completion and computed tomography after 6 months demonstrated patency of all grafts and complete exclusion of the aneurysm without any endoleak. Endovascular repair with an EIA-to-IIA endograft to preserve the pelvic inflow is a feasible and effective technique for aortoiliac aneurysms. Coil embolization might be an option to repair the distal type of endoleak. The balloon assisted U-turn technique may help advance the endovascular device over a sharp-angled vessel bifurcation.

关键词： abdominal aortic aneurysm internal iliac artery endovascular repair hybrid technique pelvic perfusion

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