Key result
Ovation Alto stent-graft implantation was successfully performed through an iliac endoconduit after retrograde subintimal recanalization in a patient with a TASC D aorto-iliac lesion and AAA.
Why the study?
Although open repair is standard for TASC D aorto-iliac lesions with coexisting AAA, endovascular treatments are increasingly used, particularly in high-risk patients.
Case Report (n=1)
Endovascular treatment using the Ovation Alto stent-graft and IVUS-guided recanalization can be performed in patients with complex TASC D aorto-iliac lesions and coexistent AAA.
Supports endovascular feasibility in complex TASC D lesions with hostile necks; leaves open need for larger prospective studies on durability.
Steno-obstructive lesion of the iliac axes and coexisting abdominal aortic aneurysm (AAA) are classified as TASC D aorto-iliac lesions. Although open surgical repair remains the gold standard, updates on stent-grafts labeling and technical improvements have resulted in a gradual replacement of open surgical bypass with endovascular treatments, especially in high-risk patients. We report a case of an infrarenal AAA with hostile proximal aortic neck associated with a chronic total occlusion of the left external iliac artery (EIA). Ovation Alto stent-graft implantation (Endologix, Santa Rosa, CA, USA) was performed through the iliac endoconduit, after EIA's retrograde subintimal recanalization with the re-entry IVUS-guided catheter.
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Cuozzo et al. (2022) conducted a case report in TASC D aorto-iliac lesion and coexistent abdominal aortic aneurysm (AAA) (n=1). Ovation Alto stent-graft implantation was evaluated. Ovation Alto stent-graft implantation was successfully performed through an iliac endoconduit after retrograde subintimal recanalization in a patient with a TASC D aorto-iliac lesion and AAA.
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