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Endovascular repair of abdominal aortic aneurysms in patients with congenital renal vascular anomalies  David B. Kaplan, MD, Christopher C. Kwon, MD,

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Presentation on theme: "Endovascular repair of abdominal aortic aneurysms in patients with congenital renal vascular anomalies  David B. Kaplan, MD, Christopher C. Kwon, MD,"— Presentation transcript:

1 Endovascular repair of abdominal aortic aneurysms in patients with congenital renal vascular anomalies  David B. Kaplan, MD, Christopher C. Kwon, MD, Michael L. Marin, MD, Larry H. Hollier, MD  Journal of Vascular Surgery  Volume 30, Issue 3, Pages (September 1999) DOI: /S (99) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 A, Preoperative computed tomographic scan shows 6.1-cm abdominal aortic aneurysm and horseshoe kidney anterior to abdominal aorta. B, Aortogram shows dominant right renal artery with two small left renal vessels. C, Pelvic angiogram shows renal branches arising from common iliac arteries. D, Artist’s rendition shows multiple accessory vessels, including isthmus arteries originating from aneurysm. E, Artist’s drawing of endovascular tube reconstruction. F, Computed tomographic scan at 2 years after endovascular tube graft repair. Full exclusion of aneurysm is seen. Journal of Vascular Surgery  , DOI: ( /S (99) ) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 A, Computed tomographic scan of patient with solitary pelvic kidney. B, Aortogram confirms solitary pelvic kidney with single renal artery originating from right common iliac artery. C, After endovascular tube graft insertion, aneurysm is excluded and the single renal artery is preserved. Journal of Vascular Surgery  , DOI: ( /S (99) ) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 Endovascular devices for repair of abdominal aortic aneurysms. A, Vanguard (Boston Scientific, Natick, Mass) endovascular graft. This device is composed of nitinol metal stent with overlying thin-walled woven Dacron graft. B, Excluder (W.L. Gore and Associates, Flagstaff, Ariz) endovascular graft. This device is composed of “Z”-configured nitinol wire with expanded polytetrafluoroethylene graft material lining internal surface. C, Parodi Palmaz balloon expandable stent graft design. This custom fabricated endograft is based on the original design of Parodi and Palmaz and uses Palmaz balloon expandable stent (Cordis Endovascular/Johnson & Johnson) sutured to tapered expanded polytetrafluoroethylene graft. Journal of Vascular Surgery  , DOI: ( /S (99) ) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 4 A, Angiogram shows accessory renal arteries arising between main renal arteries and aneurysm. B, Both accessory vessels were excluded with bifurcated endograft. Journal of Vascular Surgery  , DOI: ( /S (99) ) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 5 A, Aortograms show abdominal aortic aneurysms with accessory renal vessels originating from infrarenal neck. B, Endograft before deployment was carefully positioned so that graft portion of device would be located below accessory vessel but open portion of stent would span renal vessels. C, Completion angiograms show preservation of accessory vessels with achievement of full aneurysm exclusion. Journal of Vascular Surgery  , DOI: ( /S (99) ) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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