Preoperative selective intercostal angiography in patients undergoing thoracoabdominal aneurysm repair G.Melville Williams, MD, Glen S Roseborough, MD,

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Presentation transcript:

Preoperative selective intercostal angiography in patients undergoing thoracoabdominal aneurysm repair G.Melville Williams, MD, Glen S Roseborough, MD, Thomas H Webb, MD, Bruce A Perler, MD, Teresa Krosnick, PAC Journal of Vascular Surgery Volume 39, Issue 2, Pages 314-321 (February 2004) DOI: 10.1016/j.jvs.2003.09.039

Fig 1 Selective injection of the intercostal artery at T9 demonstrates well the great radicular artery. Such vivid demonstration was rare, and most arteriograms outlined a much less distinct hairpin turn, with less visualization of the anterior spinal artery. Journal of Vascular Surgery 2004 39, 314-321DOI: (10.1016/j.jvs.2003.09.039)

Fig 2 Flush thoracic aortogram in a patient with a fusiform extent 2 aneurysm. Note the limited distribution of intercostal arteries (arrows). In such cases the patent intercostal arteries at T6 and T7 were selected for study and reimplantation, and those arising superiorly were oversewn. Journal of Vascular Surgery 2004 39, 314-321DOI: (10.1016/j.jvs.2003.09.039)

Fig 3 Flush thoracic aortogram in a patient with subacute aortic dissection. The channel studied ended blindly, and patency was maintained with open intercostal arteries. Note the limited collateral vessel development between patent arteries and the beginning collateral vessel development distal to the occlusion. Journal of Vascular Surgery 2004 39, 314-321DOI: (10.1016/j.jvs.2003.09.039)

Fig 4 Drawings demonstrate the differences in intercostal circulation between fusiform (left) and chronic (right) dissecting aneurysms. Journal of Vascular Surgery 2004 39, 314-321DOI: (10.1016/j.jvs.2003.09.039)