@article{3030600,
    title = "Hypogastric Preservation Using a Retrograde Endovascular Bypass in a
Patient with Ruptured AAA and Concomitant Bilateral Common Iliac
Aneurysms: A Feasible Option in the Acute Setting",
    author = "Alexiou, Vangelis G. and Kakisis, John D. and Karaolanis, Georgios I. and and Baltagiannis, Evangelos G. and Ntanika, Anna and Chatzis, Dimitrios and and Koutsias, Stylianos",
    journal = "Annals of Vascular Surgery",
    year = "2021",
    volume = "74",
    pages = "497-501",
    publisher = "EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC",
    issn = "0890-5096",
    doi = "10.1016/j.avsg.2021.02.021",
    abstract = "Preservation of the hypogastric circulation is of major clinical
importance in cases of endovascular aneurysm repair (EVAR) for ruptured
abdominal aortic aneurysm (rAAA). Pelvic ischemia can be detrimental and
significantly increase post-operative morbidity and mortality. However,
the application of a side branch device or a bell-bottom graft is not
possible in ruptured aortoiliac aneurysms (due to off-the-shelf
unavailability and/or prolonged operative time) and in most cases pelvic
circulation may have to be sacrificed. We report a case of a rAAA with
bilateral common iliac artery (CIA) aneurysms that was successfully
repaired with an aorto-uni-iliac (AUI) endograft, a cross-femoral
bypass, and an inverted-U shaped contralateral EIA to IIA endovascular
bypass. The procedure is described in detail and certain technical
points are further discussed. The steps in cases where the aneurysm has
ruptured are different compared to elective repairs and vascular
surgeons need to be aware of certain pitfalls. This strategy may be
feasible in the acute setting and permits preservation of the
hypogastric circulation with the combination of standard techniques and
grafts that are readily available in most institutions."
}