Successful use of retrograde branched extension limb assembling technique in endovascular repair of pararenal abdominal aortic aneurysm Jiang Xiong,

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Presentation transcript:

Successful use of retrograde branched extension limb assembling technique in endovascular repair of pararenal abdominal aortic aneurysm Jiang Xiong, MD, PhD, Zhongzhou Hu, MD, PhD, Hongpeng Zhang, MD, PhD, Huanming Xu, MSc, Duanduan Chen, PhD, Wei Guo, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 3, Issue 2, Pages 90-94 (June 2017) DOI: 10.1016/j.jvscit.2017.02.005 Copyright © 2017 The Author(s) Terms and Conditions

Fig 1 a and b, Three-dimensional reconstruction of the aorta based on computed tomography angiography data at initial presentation and after treatment, respectively. c and d, Roots of celiac artery (CA), superior mesenteric artery (SMA), left renal artery (LRA), and right renal artery (RRA); the arrow in (c) indicates the high-grade stenosis at the origin of the CA. e and f, Angiography showing the reconstruction of the LRA and RRA, respectively. g, Three-dimensional printing model of the aneurysm. h, Surgeon-modified branched extension limb (BEL). i, Embolization of the left iliac artery. j, Reconstruction of the SMA. k, Completion aortography revealing patency of all reconstructed visceral branches without endoleak. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 90-94DOI: (10.1016/j.jvscit.2017.02.005) Copyright © 2017 The Author(s) Terms and Conditions

Fig 2 Step-by-step procedure for retrograde branched extension limb (BEL) implantation. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 90-94DOI: (10.1016/j.jvscit.2017.02.005) Copyright © 2017 The Author(s) Terms and Conditions

Fig 3 Hemodynamic evaluation of the endovascular repair. a and b, Pressure drop at systolic peak (PDsys) for the patient’s case before and after treatment as well as for a normal case. c, Flow pattern by drawing the streamlines in the aorta; the magnified images (A and B) show the vortical flows near the root of the branches. d, Distributions of time-averaged wall shear stress (TAWSS) and relative residence time (RRT) in the abdominal region after treatment; arrows indicate the regions with relatively low TAWSS and high RRT. e, Flow divisions at the visceral branches and the common iliac arteries. LCIA, Left common iliac artery; LRA, left renal artery; RCIA, right common iliac artery; RRA, right renal artery; SMA, superior mesenteric artery. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 90-94DOI: (10.1016/j.jvscit.2017.02.005) Copyright © 2017 The Author(s) Terms and Conditions