Beyond the aortic bifurcation: Branched endovascular grafts for thoracoabdominal and aortoiliac aneurysms Roy K. Greenberg, MD, Karl West, BS, Kathryn.

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Presentation transcript:

Beyond the aortic bifurcation: Branched endovascular grafts for thoracoabdominal and aortoiliac aneurysms Roy K. Greenberg, MD, Karl West, BS, Kathryn Pfaff, BS, James Foster, BS, Davorin Skender, BS, Stephan Haulon, MD, Jamie Sereika, RN, Leslie Geiger, RN, Sean P. Lyden, MD, Daniel Clair, MD, Lars Svensson, MD, PhD, Bruce Lytle, MD Journal of Vascular Surgery Volume 43, Issue 5, Pages 879-886 (May 2006) DOI: 10.1016/j.jvs.2005.11.063 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 A, Fenestrations, coupled with uncovered balloon expandable stents, were used to treat vessels that abutted but were not directly involved in the aneurysm. B, Reinforced fenestrations, whereby a nitinol ring was sutured to the perimeter of the conventional fenestration and was then coupled with a balloon-expandable stent-graft, were used to treat vessels that arose from aneurysmal aortic tissue in the setting of a small lumen and favorable angulation. C, Directional branches were used to treat vessels arising from the aortic aneurysms as well as all internal iliac branches. D, Many of these devices were used in combination. Journal of Vascular Surgery 2006 43, 879-886DOI: (10.1016/j.jvs.2005.11.063) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 A, Directional branches had anastomoses that were geometrically configured to mimic native arterial branches. B, A preloaded wire was placed retrograde through the branch such that when the graft material was unsheathed, access into the branch was established by snaring the wire. C, The directional branches were aligned to minimize the angulation between the target vessel and the aortic or iliac graft to (D) prevent kinking and optimize flow. Journal of Vascular Surgery 2006 43, 879-886DOI: (10.1016/j.jvs.2005.11.063) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions