Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal.

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Presentation transcript:

Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm M.Wayne Flye, MD, PhD, Eric T Choi, MD, Luis A Sanchez, MD, John A Curci, MD, Robert W Thompson, MD, Brian G Rubin, MD, Patrick J Geraghty, MD, Gregorio A Sicard, MD Journal of Vascular Surgery Volume 39, Issue 2, Pages 454-458 (February 2004) DOI: 10.1016/j.jvs.2003.08.022

Fig 1 Case 1. Schema of thoracoabdominal aneurysm treated with initial left iliac artery to left renal artery to superior mesenteric artery (SMA) bypass graft and subsequent placement of a thoracoabdominal endograft. Proximal superior mesenteric artery and left renal arteries were ligated. Journal of Vascular Surgery 2004 39, 454-458DOI: (10.1016/j.jvs.2003.08.022)

Fig 2 Case 1. Angiogram demonstrates patent left iliac artery to left renal artery to superior mesenteric artery bypass graft. Journal of Vascular Surgery 2004 39, 454-458DOI: (10.1016/j.jvs.2003.08.022)

Fig 3 Case 2. Schema of thoracoabdominal aneurysm treated with initial left iliac artery to left renal artery to superior mesenteric artery (SMA) and celiac axis bifurcation graft. An endograft was subsequently placed from the proximal descending thoracic aorta into the aortic bifurcation, proximal to the left iliac artery visceral vessel bypass graft. Journal of Vascular Surgery 2004 39, 454-458DOI: (10.1016/j.jvs.2003.08.022)

Fig 4 Case 3. Schema of thoracoabdominal aneurysm with aneurysmal dilatation of visceral patches, previously treated with a left iliac artery to superior mesenteric artery and hepatic artery grafts, and a saphenous vein graft to the left renal artery. Subsequently an endograft placed within the descending thoracic aortic graft extended to the old abdominal aortic graft. Journal of Vascular Surgery 2004 39, 454-458DOI: (10.1016/j.jvs.2003.08.022)

Fig 5 Case 3. Follow-up three-dimensional CT scan shows good perfusion of the visceral vessels via the left iliac artery graft after placement of the extensive endograft excluding the thoracoabdominal aneurysm. Journal of Vascular Surgery 2004 39, 454-458DOI: (10.1016/j.jvs.2003.08.022)