Transfemoral endovascular aortic graft placement

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Presentation transcript:

Transfemoral endovascular aortic graft placement Timothy A.M. Chuter, BM, BS, Richard M. Green, MD, Kenneth Ouriel, MD, William M. Fiore, MD, James A. DeWeese, MD Journal of Vascular Surgery Volume 18, Issue 2, Pages 185-197 (August 1993) DOI: 10.1016/0741-5214(93)90598-G Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A, Straight graft mounted on central carrier shows stents protruding from graft orifices. B, Proximal stent of straight graft and attachment to central carrier. C, Delivery system during insertion shows how dilator head combines with introducer sheath to create smooth, featureless external profile. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Segment of proximal stent used with bifurcated graft shows apical barb and point of graft attachment. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Bifurcated graft mounted on central carrier shows catheter used to control left limb. B, Outer end of central carrier used in bifurcated graft insertions shows locking inner and outer catheters. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Graft straightener engaging left limb of graft. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Longitudinal section of distal stent delivery system used with bifurcated grafts shows stent maintained in compressed state by sheath. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Cross-femoral catheter placement shows how basket was used to pull catheter from one side to other. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Experimental apparatus for measuring force required to displace graft 10 mm from initial position in cadaveric aorta. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 8 A, One-month angiogram of straight graft shows position of proximal stent (arrow) in relation to spine and adjacent visceral arteries. B, More caudal view of same graft at 3 months demonstrates that graft remains patent and four lumbar arteries, in region of graft, do not fill. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 9 A, Angiogram of canine aortic trifurcation shows large middle sacral artery. B, Angiogram of same dog after insertion of bifurcated graft shows position of distal stents (arrows) and absence of flow into middle sacral artery. Journal of Vascular Surgery 1993 18, 185-197DOI: (10.1016/0741-5214(93)90598-G) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions