Document Detail


Treatment of complex abdominal aortic aneurysms by a combination of endoluminal and extraluminal aortofemoral grafts.
MedLine Citation:
PMID:  8170049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was to test the hypothesis that abdominal aortic aneurysms (AAA) whose morphology makes them unsuited for repair with an endoluminal tube graft can be treated by a combination of a transluminally placed aortofemoral graft and a femorofemoral crossover graft. In addition the technique involves either ligation or balloon occlusion of the contralateral common iliac and internal iliac arteries in such a manner that excludes the AAA from the circulation.
METHODS: We report the use of this technique in three male patients with 6.4 to 7.0 cm diameter AAA. Two had renal impairment and cardiac function too poor to permit open repair, and the third had an unfavorable abdomen caused by previous surgery and the presence of a permanent colostomy. Each patient had an individually tailored Dacron tube graft constructed on the basis of preoperative arteriograms and computed tomography scans. The grafts were delivered transluminally into the aorta through a sheath in the iliac arteries and anchored proximally with a stainless steel stent under radiographic control. The grafts were then anastomosed distally to the femoral artery.
RESULTS: Recovery was complicated by a midgraft stenosis corrected by percutaneous balloon dilation in one patient, an episode of pulmonary edema in the second and an unexplained pyrexia in the third. Follow-up with duplex scanning confirmed normal flow through the grafts and the presence of thrombus between the prosthetic graft and the aneurysmal sac.
CONCLUSIONS: We conclude that transluminal placement of an aortofemoral graft combined with a femorofemoral crossover graft is feasible in patients who are unsuited to repair with an endoluminal tube graft. The outcome with this technique is not known and requires further careful evaluation.
Authors:
J May; G White; R Waugh; W Yu; J Harris
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  19     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-02     Completed Date:  1994-06-02     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  924-33     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta, Abdominal / surgery*
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis / methods*
Embolization, Therapeutic
Femoral Artery / surgery*
Humans
Iliac Artery / surgery
Ligation
Male
Polyethylene Terephthalates
Polytetrafluoroethylene
Prosthesis Design
Stents
Suture Techniques
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates; 9002-84-0/Polytetrafluoroethylene

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


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