Document Detail

Combining laparoscopic and endovascular techniques to improve the outcome of aortic endografts. Hybrid techniques.
MedLine Citation:
PMID:  16160688     Owner:  NLM     Status:  MEDLINE    
Aortic endografting can be performed with a high initial success rate yet with the need for lifelong surveillance because of numerous long term problems. Among these graft migration, typ II endoleaks and endotension require treatment to prevent abdominal aortic aneurysm (AAA) rupture. We describe our experience with laparoscopic clipping of lumbar arteries and the inferior mesenteric artery (IMA) to prevent Type II leaks as well as with different banding procedures. Several ways to perform active graft fixation are described. Since we believe that active downsizing of the aneurysm reduces some of the intermediate term problems we go a step further and evacuate the thrombus to downsize the aneurysm to prevent longitudinal shrinkage. Laparoscopic techniques can also be used to obtain direct vascular access. This permits insertion of a thoracic endograft directly into the aorta in patients with diseased iliac vessels. Endovascular aneurysm repair (EVAR) insertion under laparoscopic navigation without contrast dye in cases with renal insufficiency is described. We describe our technique of total laparoscopic conversion after failed endografting. Future perspectives and preliminary experience with an aortic stapler are discussed.
R Kolvenbach; J Lin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  46     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-14     Completed Date:  2005-12-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  415-23     Citation Subset:  IM    
Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital, Duesseldorf, Germany.
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MeSH Terms
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis Implantation / methods*
Prosthesis Design
Suture Techniques / instrumentation
Treatment Outcome

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

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