Endovascular longitudinal fenestration and stent graft placement for treatment of aneurysms developing after chronic type B aortic dissection Neal R.

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Presentation transcript:

Endovascular longitudinal fenestration and stent graft placement for treatment of aneurysms developing after chronic type B aortic dissection Neal R. Barshes, MD, MPH, Edwin C. Gravereaux, MD, Marcus Semel, MD, MPH, R. Morton Bolman, MD, Michael Belkin, MD Journal of Vascular Surgery Volume 61, Issue 5, Pages 1366-1369 (May 2015) DOI: 10.1016/j.jvs.2015.01.038 Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative computed tomography (CT) (A) two-dimensional sagittal section and (B) three-dimensional Vitrea (Vital Images Inc, Minnetonka, Minn) reconstruction, shown from left anterolateral perspective, demonstrate chronic type B aortic dissection with patent false lumen and aneurysmal dilatation. Journal of Vascular Surgery 2015 61, 1366-1369DOI: (10.1016/j.jvs.2015.01.038) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 2 Digital subtraction angiogram performed via separate injections into (A) the true lumen demonstrates the origins of lumbar arteries, the superior mesenteric artery, and the right renal artery; and (B) the false lumen demonstrates the origins of the celiac trunk and common hepatic artery, the splenic artery, the superior mesenteric artery, and the left renal artery. Journal of Vascular Surgery 2015 61, 1366-1369DOI: (10.1016/j.jvs.2015.01.038) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 3 Obliteration of the chronic aortic dissection flap (ie, re-establishment of a single lumen) was achieved by traction on a stiff guidewire “lassoed” around the false membrane. Journal of Vascular Surgery 2015 61, 1366-1369DOI: (10.1016/j.jvs.2015.01.038) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 4 Digital subtraction angiogram performed via separate injections into (A) the true lumen demonstrates the tapering of the distal thoracic aorta and faint opacification of the common hepatic, superior mesenteric artery, and right renal artery; and into (B) the false lumen demonstrates the celiac trunk, the superior mesenteric artery, and the left renal artery. Journal of Vascular Surgery 2015 61, 1366-1369DOI: (10.1016/j.jvs.2015.01.038) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 5 A, Completion thoracic angiogram and (B) abdominal aortogram demonstrate absence of filling of the aneurysmal segment of aorta and filling of all the aortic arch branches, renal arteries, and visceral branches. Journal of Vascular Surgery 2015 61, 1366-1369DOI: (10.1016/j.jvs.2015.01.038) Copyright © 2015 Society for Vascular Surgery Terms and Conditions