Name of the Procedure:

Endovascular Repair of Iliac Artery Bifurcation using Bifurcated Endograft (for aneurysm, pseudoaneurysm, arteriovenous malformation, trauma, or dissection)

Summary

An endovascular repair of the iliac artery bifurcation involves a minimally invasive technique to repair damage at the bifurcation (where the artery splits) of the iliac artery. It uses a bifurcated endograft that extends from the common iliac artery into both the external and internal iliac arteries to provide support and restore blood flow.

Purpose

This procedure addresses conditions such as aneurysms, pseudoaneurysms, arteriovenous malformations, trauma, or dissections of the iliac artery. The goal is to prevent rupture, restore normal blood flow, and reduce the risk of complications related to these vascular abnormalities.

Indications

• Presence of an iliac artery aneurysm or pseudoaneurysm.
• Arteriovenous malformation involving the iliac arteries.
• Trauma or injury to the iliac artery bifurcation.
• Dissection of the iliac artery.
• Symptoms like pain, swelling, or risk of vascular rupture.

Preparation

• Patients may need to fast for 8-12 hours before the procedure.
• Adjustments to medications, especially blood thinners, may be necessary.
• Pre-procedural imaging tests such as CT angiography or MRI.
• Blood tests and a complete medical history review.

Procedure Description

1. The patient is placed under general or regional anesthesia.
2. A small incision is made in the groin area to access the femoral artery.
3. A catheter is threaded through the artery up to the iliac artery bifurcation.
4. The bifurcated endograft is positioned at the site of the bifurcation.
5. The endograft is deployed to reinforce the vessel walls and restore normal blood flow.
6. The catheter is removed, and the incision is closed.

Duration

The procedure typically takes 2 to 4 hours.

Setting

Performed in a hospital's catheterization laboratory or a surgical center specialized in endovascular procedures.

Personnel

• Vascular surgeon or interventional radiologist
• Anesthesiologist
• Surgical nurses and technologists
• Radiologic technologist

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Endograft migration or leakage
• Blood vessel damage
• Kidney damage from contrast dye
• Allergic reaction to anesthesia or contrast dye

Benefits

• Minimally invasive with smaller incisions
• Reduced recovery time
• Lower risk of complications compared to open surgery
• Immediate stabilization of artery structure

Recovery

• Patients usually stay in the hospital for 1-2 days post-procedure.
• Instructions include limited physical activity and monitoring for signs of complications.
• Follow-up appointments to assess graft placement and condition.
• Pain management with prescribed medications.

Alternatives

• Open surgical repair (more invasive, longer recovery).
• Medical management (less effective for severe cases).
• Minimally invasive options may not be suitable for all patients, especially those with large or complex aneurysms.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be some discomfort at the incision site, managed with pain medication. Patients often experience quicker recovery and less overall discomfort compared to traditional open surgery.