A Novel Ipsilateral Approach for Secondary Iliac Branch Endoprosthesis Implantation After Previous Endovascular Aneurysm Repair

A 79-year-old man with a left common iliac artery aneurysm after previous endovascular aneurysm repair for an abdominal aortic aneurysm and a right common iliac artery aneurysm underwent secondary iliac branch endoprosthesis implantation. Because the contralateral crossover access carried a risk of stent graft migration and upper extremity access was undesirable, we developed a novel ipsilateral approach using a looped wire technique and a guiding sheath without sheath modification or steerable sheaths. Iliac branch endoprosthesis implantation was successfully achieved while preserving the internal iliac artery. This ipsilateral approach appears technically feasible and may be a useful option for secondary IBE implantation.