A new technique for reconstruction of the aortic bifurcation with saphenous vein panel graft Alexandros Mallios, MD, Benoit Boura, MD, Faris Alomran,

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Presentation transcript:

A new technique for reconstruction of the aortic bifurcation with saphenous vein panel graft Alexandros Mallios, MD, Benoit Boura, MD, Faris Alomran, MD, Myriam Combes, MD Journal of Vascular Surgery Volume 59, Issue 2, Pages 511-515 (February 2014) DOI: 10.1016/j.jvs.2013.02.245 Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative computed tomography (CT) scan. a and b, Axial view, green arrows point to the perivascular infiltration while on (b) a false aneurysm is observed; c, coronal view. Journal of Vascular Surgery 2014 59, 511-515DOI: (10.1016/j.jvs.2013.02.245) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 2 Illustration of the parameters A, X, and Y that define the necessary length of venous graft. The length (L) of the GSV required can be estimated using the equation: L = (A)(X/Y).; where A is the length of the vessel or graft that needs to be replaced, X is the perimeter of the vessel or graft that needs to be replaced, and Y is the perimeter of the saphenous vein. Journal of Vascular Surgery 2014 59, 511-515DOI: (10.1016/j.jvs.2013.02.245) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 3 Intraoperative photos. a, Explantation of the iliac stents (blue arrows); b, after suturing the two posterior (green arrows) and the unique antero-interior patch (light blue arrow), starting the suturing for the right antero-exterior patch (yellow arrow); c, before suturing the left antero-exterior patch; and d, final image after declamping. Journal of Vascular Surgery 2014 59, 511-515DOI: (10.1016/j.jvs.2013.02.245) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 4 Illustration of the reconstruction. a, Before suturing; b, after suturing the posterior patches; c, after suturing the unique antero-interior patch; and d, final view after suturing the antero-exterior patches. Journal of Vascular Surgery 2014 59, 511-515DOI: (10.1016/j.jvs.2013.02.245) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 5 Illustration of the reconstruction, axial view at the iliac (left) and aortic (right) level. Ant, Anterior; Ext, exterior; Int, interior; Post, posterior. Journal of Vascular Surgery 2014 59, 511-515DOI: (10.1016/j.jvs.2013.02.245) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 6 Postoperative computed tomography (CT) scan (3D reconstruction). a, anterior view; b, left oblique view. Journal of Vascular Surgery 2014 59, 511-515DOI: (10.1016/j.jvs.2013.02.245) Copyright © 2014 Society for Vascular Surgery Terms and Conditions