Document Detail

Access complications during endovascular aortic repair.
MedLine Citation:
PMID:  20081761     Owner:  NLM     Status:  MEDLINE    
Endovascular repair is becoming the mainstay of treatment for aneurysmal disease of the abdominal and thoracic aorta. Access related issues comprise a major reason for failure or conversion to open repair and can contribute to a significant amount of morbidity and mortality. This article will discuss a multitude of access related complications and their treatment. Preoperative imaging is paramount to the success of endovascular procedures. Intraoperative adjuncts, such as iliac artery angioplasty/stenting, the "pull-down" technique, and aorto mono iliac/femoral systems will be discussed. Occasionally, challenging iliac or femoral anatomy may preclude access through these vessels and the endovascular specialist may need to gain direct access through the aorta or via the carotid artery. In addition, the advantages and disadvantages of an entirely percutaneous technique will be discussed. Finally, peri-operative complications such as rupture, dissection, pseudoaneurysm and infection will be discussed and various treatment modalities reviewed. As stent graft technology and our own skill sets and experience continue to improve, fewer patients will be refused an endovascular repair based on access issues alone.
T L Berland; N S Cayne; F J Veith
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  51     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-18     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  43-52     Citation Subset:  IM    
NYU Langone Medical Center, New York, NY, USA.
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MeSH Terms
Aortic Aneurysm, Abdominal / pathology,  surgery*
Aortic Aneurysm, Thoracic / pathology,  surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / adverse effects*,  instrumentation
Prosthesis Design
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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