Midterm Outcomes of a Novel Physician-Modified Inner-Branch Iliac Branch Device for Internal Iliac Artery Reconstruction

The anatomical eligibility of the Iliac Branch Device (IBD) remains limited, primarily caused by the additional common iliac artery (CIA) space occupied by its outer branch. Given that East Asian populations typically have smaller CIA diameters and lengths than Western populations, the anatomical eligibility of IBD in East Asians is <30%. Thus, we developed a novel Physician-Modified Inner Iliac Branch Device (PM-IIBD) to reduce CIA spatial demands. The PM-IIBD was used for 10 patients' internal iliac artery (IIA) reconstruction, achieving a 100% technical success with no perioperative complications. The 12-month postoperative CTA follow-up showed that no type I or III endoleaks and all EIA and IIA were patent. Seven cases showed sac shrinkage, and 3 showed sac stability. This study demonstrates the safety and efficacy of the PM-IIBD in CIA lesions. The PM-IIBD significantly reduces spatial demands on the CIA, expanding the anatomical eligibility for IBD.