Relocation of the iliac artery bifurcation to facilitate endoluminal treatment of abdominal aortic aneurysms

Purpose: To report a surgical technique to preserve the internal iliac arte ries (IIAs) and facilitate endovascular repair of abdominal aortic aneurysm s (AAAs) with extensive iliac artery involvement. Technique: A new iliac artery bifurcation is created surgically through an 8-cm lower left abdominal incision by implanting the IIA onto the distal ex ternal iliac artery either directly or by using a tu be graft interposition . Careful technique is required to avoid em belie complications, but after relocating the bifurcation, aortic endografting can be performed, either si multaneously or staged, depending upon patient characteristics. Conclusions: Relocation of the iliac artery bifurcation appears to be a goo d alternative to preserve pelvic arterial flow in selected candidates for e ndoluminal AAA repair.