Crossover Chimney Technique to Preserve the Internal Iliac Artery During Endovascular Repair of Iliac or Aortoiliac Aneurysms

Purpose: To report our midterm results of the crossover chimney technique to preserve the internal iliac artery (IIA) in patients with aortoiliac aneurysms (AIA) and isolated common iliac artery aneurysms (CIAA). Methods: Between May 2012 and January 2014, 14 consecutive patients (mean age 77.3 years; all men) with 17 AIA, isolated CIAAs, or abdominal aortic aneurysms with short CIAs underwent elective endovascular aneurysm repair (EVAR) with the crossover chimney technique to preserve the IIA. Follow-up assessment, including computed tomographic angiography or duplex ultrasound, was performed at 1, 6, and 12 months and annually thereafter. Results: Technical success, defined as successful preservation of IIA without intraoperative type I or III endoleak, was 100%. Over a mean 14.3 months (range 6–21), primary patency was 92.8%. There was no early or late procedure-related mortality. Among the 17 iliac aneurysms excluded, the sac diameter significantly (at least 5 mm) decreased in 3, decreased <5 mm in 10, and did not change in 4. Conclusion: The crossover chimney technique is a simple and safe alternative for IIA endovascular revascularization with high technical success and acceptable midterm patency.