Custom-made fenestrated AnacondaTM leg extension internal iliac artery aneurysm: A case report

Introduction and importance: Internal iliac artery aneurysms repair represents a life-threatening condition due to their anatomical position and the risk of rupture. Iliac branch devices are strongly recommended for anatomically suitable patients, but limited alternatives exist when their use is unsuitable. The use of custom-made fenestrated endografts is well documented in other aortic territories, however, their application for the treatment of internal iliac artery aneurysm remains limited. Case presentation: In this innovative technique case report, we demonstrate the use of a custom-made fenestrated AnacondaTM leg extension for treating an internal iliac artery aneurysm. In the present report, we describe this technique in a patient unfit for open repair and no suitable for iliac branch device (IBD) treatment. Clinical discussion: Iliac branch devices have been designed for the treatment of iliac artery aneurysms and are associated with high technical success rates and low patient morbidity. However, their use is unsuitable for certain anatomies, and alternative therapeutic options are sparsely reported in the literature. Custom-made devices represent a feasible treatment option for aortic aneurysm repair, but despite their success in other settings, their role in treating internal iliac artery aneurysms remains poorly defined. Conclusion: Custom made iliac fenestrated devices may be a valuable treatment option for patients not eligible for IBD devices.