Iliac Artery Stenting Combined with Open Iliofemoral Endarterectomy Facilitated by a Novel Ultrasonic Ablation Instrument for Diffuse Iliofemoral Occlusive Disease

An 81-year-old male complained of intermittent claudication of the right leg. Computed tomography (CT) revealed a right external iliac artery (EIA) stenosis with severe calcification extending to the common femoral artery. A hybrid procedure of endarterectomy and stenting was performed. EIA endarterectomy was performed using a novel Cavitron Ultrasonic Surgical Aspirator which ablated the inside of the distal EIA without arterial injury. A stent graft was placed in the proximal EIA covering the margin of endarterectomized distal EIA. Postoperative CT showed no stenosis, and symptoms in the leg disappeared. This could be an alternative procedure for iliofemoral occlusive disease.