case_images: PMC11758205_01
case_images: Computed tomographic angiography (CTA) reveals severe peripheral arterial disease of the right external iliac artery (EIA) (green arrow) and the left EIA (red arrow).
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case_images: Given severe bilateral iliofemoral disease (Fig 1), open repair with aortobifemoral bypass vs iliofemoral endarterectomies with EVAR were presented to the patient as options.
case_images: Computed tomographic angiography (CTA) reveals a left axillary artery suitable to advance the endovascular stent draft during endovascular aortic aneurysm repair (EVAR).
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case_images: Chest computed tomographic angiography (CTA) was performed to evaluate alternative treatment approaches revealing a left axillary artery measuring 7 to 8 mm (Fig 2).
case_images: Reverse mounted Gore Excluder graft on an Armada balloon catheter to allow transaxillary delivery in the same orientation as a transfemoral delivery.
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case_images: Gore & Associates) was dismounted from its delivery system without deployment, and reverse mounted on a 4 x 150 mm Armada balloon catheter to allow transaxillary delivery in the same orientation as a transfemoral delivery (Fig 3).
case_images: Plain radiograph revealing final graft configuration of the Gore Excluder Endograft to exclude the abdominal aortic aneurysm (AAA).
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case_images: fig4
case_images: Completion angiogram demonstrated aneurysm exclusion with patent iliofemoral arteries and no evidence of endoleak; the final graft configuration is demonstrated on a plain radiograph (Fig 4).
case_images: Computed tomographic angiography (CTA) reveals an excluded abdominal aortic aneurysm (AAA) without endoleaks.
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case_images: fig5
case_images: At the 1-year follow-up visit, the patient reported resolution of his claudication symptoms, and CTA revealed aneurysmal sac size regression, no endoleaks, and patent bilateral profunda and superficial femoral arteries (Fig 5).