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Back-Table Surgeon Modification of a t-Branch
- Source :
- Annals of vascular surgery. 45
- Publication Year :
- 2017
-
Abstract
- Background Surgeon modification of commercially available aortic stent grafts represents a salvage option to treat complex aortic pathologies in high-risk patients. Technique A 68-year-old male was referred to our hospital with a contained rupture of the visceral aorta. The patient was previously treated with an infrarenal tube graft 16 years earlier as well as with a Crawford procedure with island patch of the celiac trunk (TC) and the superior mesenteric artery (SMA) and bypasses to both renal arteries 6 years before admission. The computed tomography demonstrated a “blowout aneurysm” of the TC and SMA patch. The bypass to the left renal artery originated from the level of the TC. We therefore modified a commercially available t-branch (Cook ® Medical, Bloomington, IN) with surgeon-made fenestrations for both renal arteries. The procedure was successful, and the patient could be discharged to home on the seventh postoperative day. Conclusions The use of surgeon-modified “off-the-shelf” t-branches broadens the possibilities of treating even anatomically very challenging aortic pathologies otherwise not suitable for the t-branch.
- Subjects :
- Male
medicine.medical_specialty
Computed Tomography Angiography
Aortic Rupture
030204 cardiovascular system & hematology
Aortic stent
Prosthesis Design
Aortography
03 medical and health sciences
Blood Vessel Prosthesis Implantation
0302 clinical medicine
Aneurysm
Blood vessel prosthesis
medicine.artery
Medicine
Humans
030212 general & internal medicine
Superior mesenteric artery
Computed tomography angiography
Aged
Surgeons
Aorta
medicine.diagnostic_test
business.industry
General Medicine
SMA
medicine.disease
Trunk
Surgery
Aortic Aneurysm
Blood Vessel Prosthesis
Treatment Outcome
Stents
Radiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 16155947
- Volume :
- 45
- Database :
- OpenAIRE
- Journal :
- Annals of vascular surgery
- Accession number :
- edsair.doi.dedup.....48435d91e6dc21bb4bb02accb6639ebf