Upside down use of Gore Excluder or Cook Zenith Legs

Purpose Endovascular aneurysm repair is becoming increasingly popular. This technical note describes the usefulness of the upside-down technique of Gore Excluder or Cook Zenith legs. Methods Four patients with iliac or abdominal aortic aneurysms were treated. Three patients with isolated iliac artery aneurysms and one patient with an abdominal aortic aneurysm, in which the neck diameters were unfit for commercially available stent-grafts, were treated using an Excluder or a Zenith leg in an upside-down technique. Results The aneurysms were completely excluded and no endoleak occurred. There were no serious adverse events. Conclusions The upside-down technique using an Excluder leg or a Zenith leg is both feasible and effective.