Clinical Application of Transluminal Endovascular Graft Placement for Aortic Aneurysms Kanji Inoue, MD, Tomoyuki Iwase, MD, Mitsuru Sato, ME, Yuki Yoshida,

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Presentation transcript:

Clinical Application of Transluminal Endovascular Graft Placement for Aortic Aneurysms Kanji Inoue, MD, Tomoyuki Iwase, MD, Mitsuru Sato, ME, Yuki Yoshida, MT, Terumitsu Tanaka, MD, Yasunobu Kubota, MD, Shunichi Tamaki, MD, Koji Hasegawa, MD, Ario Yamazato, MD The Annals of Thoracic Surgery Volume 63, Issue 2, Pages 522-528 (February 1997) DOI: 10.1016/S0003-4975(96)01214-3

Fig. 1 The way in which the graft is constructed and fixed to the carrying wire. (The relative sizes of the components of the system as shown are not as they actually are.) The Annals of Thoracic Surgery 1997 63, 522-528DOI: (10.1016/S0003-4975(96)01214-3)

Fig. 2 Transluminal endovascular graft placement procedure. (1) Graft is advanced to the predetermined target point. (2) Graft is released from the sheath. (3) Graft is pressed against the aortic wall by balloon inflation. (4) Carrying and traction wires are removed. The Annals of Thoracic Surgery 1997 63, 522-528DOI: (10.1016/S0003-4975(96)01214-3)

Fig. 3 The free end of the flexible traction wire attached to the left (right) limb is caught by a gooseneck snare wire. The Annals of Thoracic Surgery 1997 63, 522-528DOI: (10.1016/S0003-4975(96)01214-3)

Fig. 4 Aortograms of abdominal aorta before and after the procedure in patient 7. Arrows show each end of the graft. (Left) Before the procedure, an aortogram showed an infrarenal abdominal aortic aneurysm. (Right) After the procedure, an aortogram showed good flow of contrast medium through the bifurcated graft, with no leakage. The Annals of Thoracic Surgery 1997 63, 522-528DOI: (10.1016/S0003-4975(96)01214-3)

Fig. 5 Aortograms of aortic arch to descending thoracic aorta before and after the procedure in patient 16. Arrows show each end of the graft. (Left) Before the procedure, an aortogram showed a large focal aortic ulcer with a type B aortic dissection. (Right) The graft was positioned in the distal arch to exclude flow into the aneurysmal sac. Aortogram demonstrated complete resolution of the aortic ulcer after the procedure. The Annals of Thoracic Surgery 1997 63, 522-528DOI: (10.1016/S0003-4975(96)01214-3)

Fig. 6 Aortograms of abdominal aortic aorta before and after the procedure in patient 10. Arrows show each end of the graft. (Left) Before the procedure, an aortogram showed an infrarenal abdominal aortic aneurysm and large common iliac aneurysms with a severe tortuosity. (Right) Right limb was placed into the right common iliac artery and left limb was placed into the left external iliac artery. After the procedure, a small proximal leakage occurred. The Annals of Thoracic Surgery 1997 63, 522-528DOI: (10.1016/S0003-4975(96)01214-3)