Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients Joseph.

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Presentation transcript:

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients Joseph J. Ricotta, MD, MS, Nikolaos Tsilimparis, MD Journal of Vascular Surgery Volume 56, Issue 6, Pages 1535-1542 (December 2012) DOI: 10.1016/j.jvs.2012.05.096 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 A, A computed tomography (CT) scan demonstrates contained rupture of a type IV thoracoabdominal aortic aneurysm (TAAA) (arrow). B, Centerline of flow analysis reconstruction of a CT scan demonstrates rupture and preoperative measurements made to plan construction of a four-vessel fenestrated-branched device. C, Surgeon-modified Zenith TX2 endograft with four reinforced fenestrations to revascularize the visceral vessels. Journal of Vascular Surgery 2012 56, 1535-1542DOI: (10.1016/j.jvs.2012.05.096) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A, An intraoperative angiogram demonstrates rupture of the thoracoabdominal aorta. B, Intraoperative fluoroscopy shows all four fenestrations and target visceral vessels cannulated with sheaths and wires before release of diameter-reducing ties and complete deployment of the fenestrated endograft. C, Completion angiogram after successful repair of ruptured type IV thoracoabdominal aortic aneurysm (TAAA) shows patency of all four branch stents in place in the target vessels and no evidence of endoleak. Journal of Vascular Surgery 2012 56, 1535-1542DOI: (10.1016/j.jvs.2012.05.096) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A three-dimensional computed tomography (CT) angiography is shown (A) preoperatively in a patient with ruptured visceral aorta and (B) at 6 months, demonstrating no endoleak and patent branch stents to all four visceral vessels. Journal of Vascular Surgery 2012 56, 1535-1542DOI: (10.1016/j.jvs.2012.05.096) Copyright © 2012 Society for Vascular Surgery Terms and Conditions