Successful endovascular repair of juxtarenal and suprarenal aortic aneurysms with a branched stent graft Hiroaki Hosokawa, MDa, Tomoyuki Iwase, MDb,

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Presentation transcript:

Successful endovascular repair of juxtarenal and suprarenal aortic aneurysms with a branched stent graft Hiroaki Hosokawa, MDa, Tomoyuki Iwase, MDb, Mitsuru Sato, MEc, Yuki Yoshida, MTc, Katsuya Ueno, RTd, Shunichi Tamaki, MDb, Kanji Inoue, MDe Journal of Vascular Surgery Volume 33, Issue 5, Pages 1087-1092 (May 2001) DOI: 10.1067/mva.2001.114215 Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Inoue stent graft and its basic delivery system. With aid of carrying wire (arrow ) and traction wire (arrowhead ), the stent graft is delivered to optimal position. Journal of Vascular Surgery 2001 33, 1087-1092DOI: (10.1067/mva.2001.114215) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Technique of triple-branched stent graft placement. Sidearms of the branched stent graft are placed into mesenteric (SMA ) and renal arteries with 4F nylon catheters attached to each tip of branched graft sections. Journal of Vascular Surgery 2001 33, 1087-1092DOI: (10.1067/mva.2001.114215) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Placement of the branched stent graft. A , Three guidewires are inserted through 4F nylon catheters into aortic branches. B , Sidearms are introduced into aortic branches over guidewires. C , Each graft section is expanded and delivery system is removed. Arrows show each tip of sidearms. Journal of Vascular Surgery 2001 33, 1087-1092DOI: (10.1067/mva.2001.114215) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Multiplanar reformation of helical computed tomographic angiography demonstrating suprarenal abdominal aortic aneurysm in a 66-year-old man. Both renal arteries are involved in aneurysmal aorta. Journal of Vascular Surgery 2001 33, 1087-1092DOI: (10.1067/mva.2001.114215) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Aortograms obtained 1 month after triple-branched stent graft placement (arrows ) and subsequent bifurcated stent graft placement (arrowheads ) reveal absence of aneurysm filling with contrast medium and good flow through stent grafts. Mesenteric and renal arteries are patent. A , Anteroposterior projection; B , lateral projection. Journal of Vascular Surgery 2001 33, 1087-1092DOI: (10.1067/mva.2001.114215) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 6 Three-dimensional reconstruction of helical computed tomographic angiography 2 years after procedure in patient 2 showing the patency of the branched stent graft (arrowheads ). Journal of Vascular Surgery 2001 33, 1087-1092DOI: (10.1067/mva.2001.114215) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions