Endovascular treatment of aortoiliac aneurysms: Made-to-measure stent-grafts increase feasibility

We describe here our preliminary experience with use of a range of made-to- measure stent-grafts made from commercially available components. From Janu ary 1996 to June 1998, 94 aortoiliac aneurysms (AIA) were treated with sten t-grafts that were made to measure using Z autoexpandable stainless steel s tents connected with polyester sutures and covered with commercially availa ble polyester vascular prostheses. These stent-grafts were implanted throug h 18 to 24 (typically 20) Fr commercially available introducers via a surgi cal remote access. Made-to-measure tubular, bifurcated, tapered, and/or bli nd stents combined with extraanatomic bypass designs increased the rate of endovascular treatment (ET) of AIA in this series. This rate was further in creased through the use of uncovered proximal or distal stents when dealing with short or tortuous necks near major collaterals and through use of hyb rid, partly surgical designs, one with stented and the other with stentless ends, the latter allowing for a surgically made anastomosis. The results o f our experience with these techniques show that use of made to-measure ste nt-grafts greatly increases the feasibility of the ET of AIA among unselect ed patients while offering enough efficiency and safety to deserve further investigation.