Bitubular graft as an adjunct for laparoscopic hybrid repair of an abdominal aortic aneurysm Raphaël Coscas, MD, Clément Capdevila, MD, Olivier Goeau-Brissonniere,

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Presentation transcript:

Bitubular graft as an adjunct for laparoscopic hybrid repair of an abdominal aortic aneurysm Raphaël Coscas, MD, Clément Capdevila, MD, Olivier Goeau-Brissonniere, MD, PhD, Marc Coggia, MD Journal of Vascular Surgery Volume 58, Issue 1, Pages 254-257 (July 2013) DOI: 10.1016/j.jvs.2013.02.035 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 Ex-vivo preparation of the bitubular graft (BTG). Two Dacron bifurcated surgical grafts (one 18- × 9-mm graft and one 20- × 10-mm graft) are cut 1 to 2 cm below the bifurcation and one graft is inverted upside-down (A). Both grafts are connected together ex-vivo, one limb with another, using running sutures (B and C). The final BTG includes two proximal sealing zones for covered stent grafts (D). Journal of Vascular Surgery 2013 58, 254-257DOI: (10.1016/j.jvs.2013.02.035) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 Intraoperative view of laparoscopic abdominal aortic aneurysm (AAA) repair using a bitubular graft (BTG). Following the proximal anastomosis (A), the BTG is cut at the level of the main body of the distal bifurcated graft (B). The distal anastomosis is performed (C), and the final aspect of the bitubular repair is shown (D). Journal of Vascular Surgery 2013 58, 254-257DOI: (10.1016/j.jvs.2013.02.035) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 This patient presented with an abdominal aortic aneurysm (AAA) (A) extended to the left common iliac artery (CIA) (B, arrow). The use of a bitubular graft (BTG) allowed performing an aorto-aortic repair instead of an aorto-bi-iliac repair. Computed tomography scan with three-dimensional reconstruction shows the final aspect of the repair including the two covered stent grafts (C). Journal of Vascular Surgery 2013 58, 254-257DOI: (10.1016/j.jvs.2013.02.035) Copyright © 2013 Society for Vascular Surgery Terms and Conditions