Steerable sheath for exclusively femoral bilateral extension of previous FEVAR with iliac branch devices

Abstract Purpose To report the treatment of type Ib endoleak after FEVAR with iliac branch device (IBD) to allow exclusive transfemoral access without a femoral-to-femoral through-and-through wire. Technique Patient treated with FEVAR showed expansion of aneurysm due to type Ib endoleak. An IBD was implanted by the use of a contralateral steerable sheath for internal iliac artery (IIA) catheterizing. CT showed patency of target vessels and resolution of the endoleak. Conclusion The use of a steerable sheath without femoral-to-femoral through-and-through wire to bridge the IIA in patients receiving IBD after prior EVAR is feasible and avoids the risks associated with upper extremity access.