![]() ![]() A bifurcated endograft was implanted with specific, in-situ, branching to the target hypogastric artery and achieved clinical and technical success, in all the patients. All patients eligible for this approach were considered unfit for open repair and were not suitable for an iliac branch graft (Z-BIS Zenithâ„¢ Cook Medical). The study included four patients treated from April 2010 until November 2010 with the modified Sandwich technique. This paper describes how the Sandwich-Graft technique was adapted, as described by Lobato et al., employing the Aorfixâ„¢ system (Lombard Medical) and the Viabahnâ„¢ (W.L.Gore) to preserve hypogastric flow in cases with extreme neck angulation and iliac tortuosity. Since the introduction of the first endoprosthetic devices, continuous development in techniques and implants has occurred, such as the introduction of a stent graft with branches designed to preserve antegrade flow in the hypogastric artery, a stent-graft designed to treat extreme neck angulation and iliac tortuosity, as well as "Sandwich" and "Chimney" techniques used to maintain perfusion in branch vessels originating in the region to be treated. Mosquera Arochena, N RodrÃguez Feijoo, G Carballo Fernandez, C Molina Herrero, F Fernandez Lebrato, R Barrios Castro, A Garcia Fernandez, I Use of modified Sandwich-graft technique to preserve hypogastric artery in EVAR treatment of complex aortic aneurysm anatomy. ![]()
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