Aortoscopy: A guidance system for endoluminal aortic surgery

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Presentation transcript:

Aortoscopy: A guidance system for endoluminal aortic surgery Bradley B. Hill, MD, Gordon L. Hyde, MD, Chien-Suu Kuo, MD, Fang K. Loh, MD, L.Hart Wright, ATR, Warwick A. Arden, DVM, PhD, Timothy J. Nypaver, MD, Christopher J. Kwolek, MD Journal of Vascular Surgery Volume 24, Issue 3, Pages 439-448 (September 1996) DOI: 10.1016/S0741-5214(96)70200-8 Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Aortoscope assembly consists of 1.9 mm Intramed angioscope inserted through 9F balloon-tipped catheter; balloon insufflated with clear solution by way of 0.6 mm working channel. Journal of Vascular Surgery 1996 24, 439-448DOI: (10.1016/S0741-5214(96)70200-8) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Digitized image of endoluminal pig aorta looking distally through aortoscope; large arrow shows right renal artery orifice; small arrow shows left renal artery orifice cannulated with angiogram catheter from femoral artery; bright spot in center is light reflecting off inside surface of aortoscope balloon; branching arteries and distal aortic lumen appear as red spots against pale color of aortic intima. (Resolution of image in photograph limited by lack of color and absence of consecutive real-time video images.) Journal of Vascular Surgery 1996 24, 439-448DOI: (10.1016/S0741-5214(96)70200-8) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Diagram depicts endoluminal distances measured. R, Renal (inferior edge of most inferior renal artery orifice); T, trifurcation; D, device (proximal end of stent or graft); TAL is distance from inferior edge of most inferior renal artery orifice to distal aortic trifurcation; TAL = T - R; Device Placement Error is distance from inferior edge of most inferior renal artery orifice to proximal edge of stent or graft; DPE = D - R. Journal of Vascular Surgery 1996 24, 439-448DOI: (10.1016/S0741-5214(96)70200-8) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Postmortem dissection of pig shows position of Palmaz stent (P308) used in abdominal aorta with aortoscopic guidance only; proximal end of stent aligned exactly with inferior edge of most inferior renal artery orifice. Journal of Vascular Surgery 1996 24, 439-448DOI: (10.1016/S0741-5214(96)70200-8) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Problem with “fighting balloons” depicted; tapered tip of deployment balloon interferes with aortoscopic view of proximal graft edge during graft expansion. Journal of Vascular Surgery 1996 24, 439-448DOI: (10.1016/S0741-5214(96)70200-8) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions