Use of Secondary Iliac Branch Devices After Previous Endovascular Abdominal Aortic Aneurysm Repair

Objective: Type 1b endoleaks might occur after endovascular aortic repair (EVAR) due to the degeneration of the distal sealing zones, with an incidence of 3.5% during follow up.1 Given the importance of the internal iliac artery (IIA) in maintaining pelvic perfusion, iliac branch devices (IBD) have been used to treat secondary type 1b endoleaks or even de novo IIA aneurysms. The treatment with a secondary IBD after a previous implanted EVAR may be challenging with upper extremity or complex crossover access required to maintain the IIA. The aim of this study is to report technical aspects, early and long term outcomes of secondary IBD after previous EVAR.