Document Detail


Direct videoscopic approach to the thoracic aorta for aortic endograft delivery: evaluation in a human cadaver circulation model.
MedLine Citation:
PMID:  20199259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine the feasibility of a direct videoscopic approach to the descending thoracic aorta for branched endograft delivery to the aortic arch and abdominal aorta. METHODS: Aneurysms were created in the aortic arch and pararenal aorta of 3 human cadavers, and pulsatile flow was established using a roller pump. Thoracoscopically, 2 double-felted purse-string sutures were placed on the thoracic aorta. Via the most distal trocar, an endoscopic needle was used to insert a stiff guidewire into the aorta through the center of the purse-string suture. Under direct videoscopic control, a 20-F sheath was advanced over the wire into the aorta. Switching to fluoroscopic control, a fenestrated endograft was deployed in the aortic arch followed by placement of a branch graft into the left subclavian artery. The delivery sheath was withdrawn from the aorta while simultaneously tightening the purse-string sutures. A similar procedure was performed in the same cadaver for antegrade branched endograft delivery to the pararenal aorta. Correct deployment of the branched endografts was evaluated by post implant angiography and autopsy. RESULTS: The procedure was successfully completed in all cadavers. "Hemostasis" was obtained in all cadavers without aortic cross clamping. Median fluid loss was 165 mL. Autopsy proved all purse-string sutures to be adequately placed and all branched endografts to be deployed in the correct position. CONCLUSION: A direct videoscopic approach to the descending thoracic aorta proved a feasible technique for branched endograft delivery to the aortic arch and abdominal aorta in a human cadaver model.
Authors:
Vincent Jongkind; Kak K Yeung; Matteus A M Linsen; David Heidsieck; Hans M E Coveliers; Arjan W J Hoksbergen; Willem Wisselink
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  17     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-04     Completed Date:  2010-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  12-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, VU University Medical Center, Amsterdam 1007 MB, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aorta, Thoracic / physiopathology,  radiography,  surgery*
Aortic Aneurysm, Abdominal / physiopathology,  radiography,  surgery*
Aortic Aneurysm, Thoracic / physiopathology,  radiography,  surgery*
Autopsy
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / instrumentation,  methods*
Cadaver
Feasibility Studies
Female
Humans
Patient Positioning
Prosthesis Design
Pulsatile Flow
Radiography, Interventional
Stents
Suture Techniques
Thoracic Surgery, Video-Assisted*
Comments/Corrections
Comment In:
J Endovasc Ther. 2010 Feb;17(1):19-20   [PMID:  20199260 ]

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


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