Transition From Fenestrations and Outer Branches to a Novel Mini Inner Branch Technique for Internal Iliac Artery Preservation Using Physician-modified Endurant Limbs

PMEG configurations are feasible alternatives for IIA preservation in narrow or resource-limited settings. The mini-inner branch offers a promising balance between sealing and procedural simplicity, but long-term evaluation is warranted.Clinical ImpactThis study presents a novel mini-inner branch design for physician-modified Endurant limbs, offering a practical solution for internal iliac artery preservation in patients with narrow iliac anatomy. The design improves sealing and simplifies resheathing without requiring larger sheaths. It expands endovascular options where standard iliac branch devices are not feasible, supporting safer and more adaptable aneurysm repair in challenging anatomies.