Novel Stent Graft Design to Reduce Access Site Puncture Diameter for Endovascular Repair of Infra-Renal Abdominal Aortic Aneurysms: First Two Cases

Abstract We report on an innovative approach in two patients to reduce the access size in the contralateral access which has the potential to reduce access site complications, particularly in patients with smaller femoral arteries. The device is developed by using a standard EVAR device with customized modification of its structure according to the patient’s anatomy. It comprises of a bifurcated stent graft. a proximal extension graft and a contra-lateral limb extension. In our first two cases, we demonstrated that our design, which include direct flow from the abdominal aorta to the ipsilateral limb and retrograde flow to contra-lateral limb worked very well in terms of sealing, with no endoleaks observed, as well as inflow in the stent graft. While long-term results and further refinement are awaited, this approach holds potential in reducing access-related complications and expanding the options for EVAR in patients with small femoral arteries.