Upside-Down Deployment of the Minos Iliac Limb as a Simple Off-the-Shelf Solution to Overcome Anatomical Limits

For isolated internal iliac artery (IIA) aneurysms with tapered anatomy extending from the common iliac artery (CIA) to the external iliac artery (EIA), upside-down deployment of an iliac limb after IIA embolization is a practical alternative. However, conventional techniques for upside-down modific...

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Bibliographic Details
Main Authors: Hyeonju Kim, Deokbi Hwang, Seung Huh, Hyung-Kee Kim
Format: Article
Language:English
Published: Medrang 2025-06-01
Series:Vascular Specialist International
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Online Access:http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.250034
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Summary:For isolated internal iliac artery (IIA) aneurysms with tapered anatomy extending from the common iliac artery (CIA) to the external iliac artery (EIA), upside-down deployment of an iliac limb after IIA embolization is a practical alternative. However, conventional techniques for upside-down modifications typically require external removal, inversion, and reinsertion of the stent-graft, which can be cumbersome and time-consuming. This study presents the first report of a simplified upside-down deployment technique that utilizes the Minos iliac limb. After cutting the nose cone, a 12 Fr Minos iliac limb was preloaded in reverse orientation into a 14 Fr sheath, without external manipulation or reloading. Following distal IIA embolization, the stent-graft was deployed by unsheathing to accommodate the tapered anatomy from the CIA to the EIA. This technique provides a streamlined, off-the-shelf solution for anatomically challenging iliac aneurysms and offers an effective alternative when standard deployment methods are not feasible.
ISSN:2288-7970
2288-7989