Endovascular treatment of aorto-iliac aneurysms: Made-to-measure endoprostheses increase the feasibility

The authors describe their experience of tailoring endoprostheses for endov ascular treatment of aorto-iliac aneurysms with components available on the market. Between January 1996 and December 1999, 188 aorto-iliac aneurysms were trea ted by tailor-made endoprostheses using self-expanding Z stents made of sta inless steel compiled with polyester ligatures and covered with standard co mmercially available polyester prostheses. These endoprostheses were implan ted with an 18 to 24 Pr (usually 20 Pr) introducer and positioned by a surg ical approach. This method allows construction of tubular, bifurcated, digr essive or occlusive endoprostheses associated with an extra-anatomical bypa ss graft. It increased the number of endovascular procedures for aorto-ilia c aneurysms in the authors' department. This number has been further increa sed by using endoprostheses with an uncovered proximal or distal stent for cases with particularly short or angled necks and by using hybrid endoprost heses with one or more extremities without a stent, allowing surgical sutur e of the anastomosis. The authors' results show that tailoring endoprostheses considerably increa sed the feasibility of endovascular treatment of aorto-iliac aneurysms, eve n in unselected patients whilst providing an effectiveness and safety to ju stify the continuation of this experience.