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Sutureless telescoping aortic anastomotic technique for hybrid surgical treatment of aortoiliac occlusive disease


Donas, K P; Rancic, Z; Frauenfelder, T; Ueda, H; Lachat, Mario L; Veith, F J; Mayer, D (2010). Sutureless telescoping aortic anastomotic technique for hybrid surgical treatment of aortoiliac occlusive disease. Journal of Endovascular Therapy, 17(2):251-254.

Abstract

PURPOSE: To describe a new technique to assist aortoiliac stent-graft implantation in the presence of severe and extensive calcification. TECHNIQUE: The use of an aortic stent-graft telescoped into the aorta and deployed partly within and partly outside the aorta is illustrated in 2 cases. In the first, the bifurcated stent-graft was deployed with the proximal end and body intraluminally within the aorta; the distal ends (legs) were extended in an extravascular fashion with surgical grafts to reach the femoral bifurcation. In the second case, a tapered tubular stent-graft was deployed through the aortic wall to land partially inside the aortic lumen and partly inside a bifurcated standard surgical graft; the distal ends of the surgical graft were anastomosed to the iliac arteries by a standard anastomosis on the left and by an intraluminal telescoped stent-graft anastomosis on the right. Follow-up was uneventful in both patients. The sutureless telescoping anastomosis was stable at 5 years and 6 months, respectively, on computed tomographic angiography. CONCLUSION: These favorable outcomes underscore that this technique should be considered in patients with aortoiliac occlusive disease in whom aortic cross-clamping and/or a standard aortic anastomosis is expected to be difficult or impossible.

Abstract

PURPOSE: To describe a new technique to assist aortoiliac stent-graft implantation in the presence of severe and extensive calcification. TECHNIQUE: The use of an aortic stent-graft telescoped into the aorta and deployed partly within and partly outside the aorta is illustrated in 2 cases. In the first, the bifurcated stent-graft was deployed with the proximal end and body intraluminally within the aorta; the distal ends (legs) were extended in an extravascular fashion with surgical grafts to reach the femoral bifurcation. In the second case, a tapered tubular stent-graft was deployed through the aortic wall to land partially inside the aortic lumen and partly inside a bifurcated standard surgical graft; the distal ends of the surgical graft were anastomosed to the iliac arteries by a standard anastomosis on the left and by an intraluminal telescoped stent-graft anastomosis on the right. Follow-up was uneventful in both patients. The sutureless telescoping anastomosis was stable at 5 years and 6 months, respectively, on computed tomographic angiography. CONCLUSION: These favorable outcomes underscore that this technique should be considered in patients with aortoiliac occlusive disease in whom aortic cross-clamping and/or a standard aortic anastomosis is expected to be difficult or impossible.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:April 2010
Deposited On:10 Jun 2010 13:21
Last Modified:07 Dec 2017 02:39
Publisher:International Society of Endovascular Specialists
ISSN:1526-6028
Publisher DOI:https://doi.org/10.1583/09-2953.1
PubMed ID:20426649

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