Percutaneous treatment of severe diffuse stenosis in heavily calcified infrarenal abdominal aorta using iliac extender endoprosthesis: a case series.

Severe, concentric calcific stenosis of the infrarenal abdominal aorta (IAA) is an uncommon but technically challenging problem. In diffuse, heavily calcific lesions are generally not treated with balloon expandable or self-expanding stents. There is concern of aortic rupture, incomplete apposition, and underexpansion. Such lesions are mostly treated with aortobifemoral or extra-anatomic bypass surgery. Using three case examples, we describe the feasibility of endovascular treatment for severely calcific IAA with use of iliac extender limbs of commercially available aortic stent grafts and discuss the role of preprocedural CT scan in case planning.