Name of the Procedure:

Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft (also known as endovascular iliac artery aneurysm repair)

Summary

Endovascular iliac artery repair involves the placement of a tube-like graft within the iliac artery to repair an aneurysm or other arterial damage. The procedure is minimally invasive and uses a catheter inserted through the blood vessels to position the endograft.

Purpose

This procedure aims to reinforce and stabilize a weakened or damaged iliac artery, preventing rupture or further complications. The primary goal is to restore normal blood flow and avert life-threatening conditions such as internal bleeding.

Indications

• Presence of an iliac artery aneurysm
• Symptoms of claudication or critical limb ischemia
• Evidence of arterial dissection or rupture

Preparation

• Fasting for at least 6-8 hours before the procedure
• Adjusting or discontinuing certain medications as advised by the healthcare provider
• Pre-procedure imaging tests like CT scans or MRIs to assess the artery and plan the procedure

Procedure Description

1. Pre-procedure sizing and device selection are conducted using imaging tools.
2. The patient is usually placed under general anesthesia or conscious sedation.
3. A small incision is made in the groin area to access the femoral artery.
4. A catheter is guided through the blood vessel to the iliac artery.
5. The ilio-iliac tube endograft is deployed through the catheter and positioned across the damaged area.
6. Real-time X-ray imaging is used for guidance and to ensure proper placement.
7. The endograft is expanded to fit snugly against the arterial wall.
8. The catheter is removed, and the incision is closed.

Duration

The procedure typically takes 1 to 3 hours.

Setting

This procedure is performed in a hospital's vascular surgery or interventional radiology suite.

Personnel

• Vascular surgeon or interventional radiologist
• Anesthesiologist
• Surgical nurses
• Radiology technicians

Risks and Complications

• Infection at the incision site
• Blood vessel damage
• Endoleak (leakage around the graft)
• Reaction to contrast dye
• Blood clots
• Stroke
• Infection of the graft

Benefits

• Minimally invasive approach with faster recovery compared to open surgery
• Reduced risk of complications associated with aneurysm rupture
• Immediate stabilization of the aneurysm

Recovery

• Hospital stay for 1-2 days for monitoring and recovery
• Instructions for wound care and activity restrictions
• Follow-up imaging tests to ensure the graft is functioning properly
• Gradual return to normal activities over several weeks

Alternatives

• Open surgical repair: more invasive, longer recovery, but effective in certain cases
• Watchful waiting: monitoring the aneurysm size and health over time, suitable for small or asymptomatic aneurysms

Patient Experience

During the procedure, the patient will be sedated or under anesthesia and thus should not feel discomfort. Post-procedure, there may be mild pain at the incision site, managed with pain medications. The patient can expect to resume normal activities gradually, following post-care guidelines provided by the healthcare team.