Fenestrated Endograft

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Presentation transcript:

Fenestrated Endograft

Fenestrated aortic endograft - Planning CTA 1mm tickness MPR 3 D CLL evaluation

Fenestrated endograft – Anatomical considerations Proximal neck angulation < 45° Distal neck angulation < 45° No circumferential sealin zone thrombus/calcification Absence of aorto-iliac: occlusive disease tortuosity calcification

Fenestrated endograft – Anatomical considerations Ensure 2 cm sealing zone above AAA No visceral vessels stenosis (>50 %) No small Ø visceral vessels (≥5 mm) No severe visceral vessels angulation Adequate (>15 mm) main visceral vessel lenght

Fenestrated endograft

Fenestrated endograft

Bifurcated Endograt

12:00 9:00 3:00 6:00

Visceral vessels distance evaluation

Baseline Lower CT

Baseline Lower CT Mid SMA

Baseline Lower CT Lower SMA

Baseline Lower CT Mid SMA Mid LRA

Baseline Lower CT Mid SMA Mid LRA Mid RRA

Baseline Lower CT Lower SMA 2 mm below Mid LRA Mid RRA

TOP OF THE GRAFT Baseline Lower CT 12 mm Lower SMA 2 mm below Mid LRA Mid RRA

Baseline Lower CT TOP OF THE GRAFT 12 mm Lower SMA Mid LRA Mid RRA

Baseline Lower CT TOP OF THE GRAFT 12 mm Lower SMA Mid LRA Mid RRA

Endoprotesi Fenestrate nel trattamento degli AAA Planning TAC Impianto 4 – 6 settimane

Follow up 3 years

Follow up 3 years

Vascular Surgery – University of Bologna B.A. male, 65 years COPD CAD (IMA) BMI 31.9 AAA Ø 52 mm Creatinine 1.2 mg/dl ASA: III Vascular Surgery – University of Bologna

2012

Vascular Surgery – University of Bologna MPR Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Risk factors for type II endoleaks MPR IMA Lumbars Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Visceral vessels evaluation Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Visceral vessels evaluation Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Visceral vessels evaluation Clock View SMA 12.15 Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Visceral vessels evaluation Clock View LRA 15.00 Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Visceral vessels evaluation RRA Center Lumen Line Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Visceral vessels evaluation Clock View LRA 9.30 Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Fenestrated endograft Fenestrated module CT Scallop SMA large fenestraion RRA small fenestration LRA small fenestration Bifurcated endograft Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Fenestrated endograft Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Bone landmarks T12 Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Bone landmarks L5 Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Femoral Access Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Pre-operative C-Arm evaluation . Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Pre-operative C-Arm evaluation 20° . Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna Pre-operative C-Arm evaluation 90° . Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna

Vascular Surgery – University of Bologna