Novel Surgeon-Modified Fenestrated Iliac Stent Graft.

Jungi, Silvan; Papazoglou, Dimitrios D; Chan, Hon-Lai; Schmidli, Jürg; Makaloski, Vladimir (2023). Novel Surgeon-Modified Fenestrated Iliac Stent Graft. (In Press). Journal of endovascular therapy, p. 15266028231173311. Sage 10.1177/15266028231173311

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We describe the feasibility and early results of a novel endovascular approach with a surgeon-modified fenestrated iliac stent graft to preserve pelvic perfusion in patients with iliac aneurysms not suitable for iliac branch devices (IBDs).


Seven high-risk patients, median age 76 years (range 63-83), with a complex aortoiliac anatomy with contraindications for commercially available IBDs were treated with a novel surgeon-modified fenestrated iliac stent graft between August 2020 and November 2021. The modified device was built using an iliac limb stent graft (Endurant II Stent Graft; Medtronic), which was partially deployed, surgically fenestrated with a scalpel, reinforced, re-sheathed, and inserted via femoral access. The internal iliac artery was cannulated and bridged with a covered stent. Technical success rate was 100%. After a median follow-up period of 10 months, there was 1 type II endoleak and no migrations, stent fractures, or loss of device integrity. One iliac limb occlusion occurred after 7 months, which needed a secondary endovascular intervention, restoring patency.


Surgeon-modified fenestrated iliac stent graft is feasible and might be used as an alternative in patients with a complex iliac anatomy not suitable to commercially available IBDs. Long-term follow-up is needed to evaluate stent graft patency and potential complications.


Surgeon modified fenetrated iliac stent grafts might be a promising alternative to iliac branch devices, extending endovascular solutions to a broader patient population with complex aorto-iliac anatomies preserving antegrade internal iliac artery perfusion. It is possible to treat small iliac bifurcations and large angulations of the iliac bifurcation safely and there is no need for a contralateral or upper-extremity access.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery

UniBE Contributor:

Jungi, Silvan, Papazoglou, Dimitrios David, Chan, Hon Lai, Schmidli, Jürg, Makaloski, Vladimir


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

17 May 2023 08:31

Last Modified:

27 Feb 2024 14:27

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

aortoiliac aneurysm endograft endovascular aortic repair fenestration surgeon-modified


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