Analysis of covered endovascular reconstruction of aortic bifurcation technique for aortoiliac disease_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QI Yuhan , WENG Chengxin , HUANG Bin , WANG Tiehao , DU Xiaojiong , ZHAO Jichun ,  YUAN Ding

Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

YUAN Ding, Email: docyuanding@gmail.com

Keywords：

aortic bifurcation; aortoiliac; endovascular; CERAB; balloon-expandable covered stent

DOI：

10.7507/1007-9424.202205059

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the main points and advantages of covered endovascular reconstruction of aortic bifurcation (CERAB) technique in the treatment of complex aortic and iliac artery lesions. Method The data of the patient with bilateral common iliac artery stenosis and lower abdominal aortic calcification treated by CERAB technology in the Department of Vascular Surgery of West China Hospital of Sichuan University and the technology in combination with the characteristics of balloon-expandable covered stent were analyzed. Results The lesions were successfully treated by CERAB technique. The stents of bilateral iliac arteries were in perfect shape and good adherence. The radiography of the abdominal aorta and bilateral internal and external iliac arteries were well displayed. Conclusions From analysis results of this case, CERAB technology is effective and feasible in treatment of lesions at the bifurcation of the main aortic and iliac artery. The shape of aortic bifurcation is satisfactorily recovered. The key point for the successful implementation of this technology is balloon-expandable covered stent.

Citation： QI Yuhan, WENG Chengxin, HUANG Bin, WANG Tiehao, DU Xiaojiong, ZHAO Jichun, YUAN Ding. Analysis of covered endovascular reconstruction of aortic bifurcation technique for aortoiliac disease. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(7): 852-856. doi: 10.7507/1007-9424.202205059 Copy

1.	Aboyans V, Ricco JB, Bartelink MEL, et al. Editor’s choice—2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society For Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg, 2018, 55(3): 305-368.
2.	Conte MS, Bradbury AW, Kolh P, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg, 2019, 69(6S): 3S-125S. e40. doi: 10.1016/j.jvs.2019.02.016.
3.	Groot Jebbink E, Mathai V, Boersen JT, et al. Hemodynamic comparison of stent configurations used for aortoiliac occlusive disease. J Vasc Surg, 2017, 66(1): 251-260.
4.	Groot Jebbink E, Grimme FA, Goverde PC, et al. Geometrical consequences of kissing stents and the covered endovascular reconstruction of the aortic bifurcation configuration in an in vitro model for endovascular reconstruction of aortic bifurcation. J Vasc Surg, 2015, 61(5): 1306-1311.
5.	Feldman DN, Armstrong EJ, Aronow HD, et al. SCAI guidelines on device selection in aorto-iliac arterial interventions. Catheter Cardiovasc Interv, 2020, 96(4): 915-929.
6.	Reijnen MM. Update on covered endovascular reconstruction of the aortic bifurcation. Vascular, 2020, 28(3): 225-232.
7.	Groot Jebbink E, Holewijn S, Slump CH, et al. Systematic review of results of kissing stents in the treatment of aortoiliac occlusive disease. Ann Vasc Surg, 2017, 42: 328-336.
8.	Greiner A, Mühlthaler H, Neuhauser B, et al. Does stent overlap influence the patency rate of aortoiliac kissing stents? J Endovasc Ther, 2005, 12(6): 696-703.
9.	Vértes M, Juhász IZ, Nguyen TD, et al. Stent protrusion >20 mm into the aorta: a new predictor for restenosis after kissing stent reconstruction of the aortoiliac bifurcation. J Endovasc Ther, 2018, 25(5): 632-639.
10.	Rigatelli G, Zuin M, Dell’Avvocata F, et al. Non-invasive evaluation of fluid dynamic of aortoiliac atherosclerotic disease: impact of bifurcation angle and different stent configurations. J Transl Int Med, 2018, 6(3): 138-145.
11.	Groot Jebbink E, Ter Mors TG, Slump CH, et al. In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease. Vascular, 2017, 25(6): 635-641.
12.	Groot Jebbink E, Engelhard S, Lajoinie G, et al. Influence of iliac stenotic lesions on blood flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) stent configuration. J Endovasc Ther, 2017, 24(6): 800-808.
13.	Taeymans K, Groot Jebbink E, Holewijn S, et al. Three-year outcome of the covered endovascular reconstruction of the aortic bifurcation technique for aortoiliac occlusive disease. J Vasc Surg, 2018, 67(5): 1438-1447.
14.	Blais B, Carr K, Sinha SP, et al. Mechanical properties of low-diameter balloon expandable covered stents. Catheter Cardiovasc Interv, 2021, 97(3): 451-458.
15.	Bekken JA, Jongsma H, Fioole B. The use of covered stents in aortoiliac obstructions: a systematic review and meta-analysis. J Cardiovasc Surg (Torino), 2018, 59(1): 14-25.
16.	Dijkstra ML, Goverde PC, Holden A, et al. Initial experience with covered endovascular reconstruction of the aortic bifurcation in conjunction with chimney grafts. J Endovasc Ther, 2017, 24(1): 19-24.

1. Aboyans V, Ricco JB, Bartelink MEL, et al. Editor’s choice—2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society For Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg, 2018, 55(3): 305-368.
2. Conte MS, Bradbury AW, Kolh P, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg, 2019, 69(6S): 3S-125S. e40. doi: 10.1016/j.jvs.2019.02.016.
3. Groot Jebbink E, Mathai V, Boersen JT, et al. Hemodynamic comparison of stent configurations used for aortoiliac occlusive disease. J Vasc Surg, 2017, 66(1): 251-260.
4. Groot Jebbink E, Grimme FA, Goverde PC, et al. Geometrical consequences of kissing stents and the covered endovascular reconstruction of the aortic bifurcation configuration in an in vitro model for endovascular reconstruction of aortic bifurcation. J Vasc Surg, 2015, 61(5): 1306-1311.
5. Feldman DN, Armstrong EJ, Aronow HD, et al. SCAI guidelines on device selection in aorto-iliac arterial interventions. Catheter Cardiovasc Interv, 2020, 96(4): 915-929.
6. Reijnen MM. Update on covered endovascular reconstruction of the aortic bifurcation. Vascular, 2020, 28(3): 225-232.
7. Groot Jebbink E, Holewijn S, Slump CH, et al. Systematic review of results of kissing stents in the treatment of aortoiliac occlusive disease. Ann Vasc Surg, 2017, 42: 328-336.
8. Greiner A, Mühlthaler H, Neuhauser B, et al. Does stent overlap influence the patency rate of aortoiliac kissing stents? J Endovasc Ther, 2005, 12(6): 696-703.
9. Vértes M, Juhász IZ, Nguyen TD, et al. Stent protrusion >20 mm into the aorta: a new predictor for restenosis after kissing stent reconstruction of the aortoiliac bifurcation. J Endovasc Ther, 2018, 25(5): 632-639.
10. Rigatelli G, Zuin M, Dell’Avvocata F, et al. Non-invasive evaluation of fluid dynamic of aortoiliac atherosclerotic disease: impact of bifurcation angle and different stent configurations. J Transl Int Med, 2018, 6(3): 138-145.
11. Groot Jebbink E, Ter Mors TG, Slump CH, et al. In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease. Vascular, 2017, 25(6): 635-641.
12. Groot Jebbink E, Engelhard S, Lajoinie G, et al. Influence of iliac stenotic lesions on blood flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) stent configuration. J Endovasc Ther, 2017, 24(6): 800-808.
13. Taeymans K, Groot Jebbink E, Holewijn S, et al. Three-year outcome of the covered endovascular reconstruction of the aortic bifurcation technique for aortoiliac occlusive disease. J Vasc Surg, 2018, 67(5): 1438-1447.
14. Blais B, Carr K, Sinha SP, et al. Mechanical properties of low-diameter balloon expandable covered stents. Catheter Cardiovasc Interv, 2021, 97(3): 451-458.
15. Bekken JA, Jongsma H, Fioole B. The use of covered stents in aortoiliac obstructions: a systematic review and meta-analysis. J Cardiovasc Surg (Torino), 2018, 59(1): 14-25.
16. Dijkstra ML, Goverde PC, Holden A, et al. Initial experience with covered endovascular reconstruction of the aortic bifurcation in conjunction with chimney grafts. J Endovasc Ther, 2017, 24(1): 19-24.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of covered endovascular reconstruction of aortic bifurcation technique for aortoiliac disease

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