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Fenestrated Endograft. Fenestrated aortic endograft - Planning CTA 1mm tickness MPR 3 D CLL evaluation.

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Presentation on theme: "Fenestrated Endograft. Fenestrated aortic endograft - Planning CTA 1mm tickness MPR 3 D CLL evaluation."— Presentation transcript:

1 Fenestrated Endograft

2 Fenestrated aortic endograft - Planning CTA 1mm tickness MPR 3 D CLL evaluation

3 Fenestrated endograft – Anatomical considerations Proximal neck angulation < 45° Distal neck angulation < 45° No circumferential sealin zone thrombus/calcification Absence of aorto-iliac: occlusive disease tortuosity calcification

4 Fenestrated endograft – Anatomical considerations Ensure 2 cm sealing zone above AAA No visceral vessels stenosis (>50 %) No small Ø visceral vessels (5 mm) No severe visceral vessels angulation Adequate (>15 mm) main visceral vessel lenght

5 Fenestrated endograft

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7 Bifurcated Endograt

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10 12:00 9:00 3:00 6:00

11 Visceral vessels distance evaluation

12 Lower CT Baseline

13 Lower CTBaseline Mid SMA

14 Lower CTBaseline Lower SMA

15 Lower CTBaseline Mid SMA Mid LRA

16 Lower CTBaseline Mid SMA Mid LRA Mid RRA

17 Lower CTBaseline Lower SMA Mid LRA Mid RRA 2 mm below

18 Lower CTBaseline Lower SMA Mid LRA Mid RRA 2 mm below TOP OF THE GRAFT 12 mm

19 Lower CTBaseline Lower SMA Mid LRA Mid RRA TOP OF THE GRAFT 12 mm

20 Lower CTBaseline Lower SMA Mid LRA Mid RRA TOP OF THE GRAFT 12 mm

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24 Endoprotesi Fenestrate nel trattamento degli AAA Planning TACImpianto 4 – 6 settimane

25 Follow up 3 years

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27 B.A. male, 65 years COPD CAD (IMA) BMI31.9 AAA Ø 52 mm Creatinine 1.2 mg/dl ASA: III Vascular Surgery – University of Bologna

28 2012

29 MPR Vascular Surgery – University of Bologna

30 MPR Vascular Surgery – University of Bologna Risk factors for type II endoleaks IMA Lumbars

31 Visceral vessels evaluation Vascular Surgery – University of Bologna

32 Visceral vessels evaluation

33 Vascular Surgery – University of Bologna Clock View SMA 12.15

34 Visceral vessels evaluation Clock View LRA Vascular Surgery – University of Bologna

35 Visceral vessels evaluation RRA Center Lumen Line Vascular Surgery – University of Bologna

36 Visceral vessels evaluation Clock View LRA 9.30 Vascular Surgery – University of Bologna

37 Fenestrated endograft Fenestrated module CT Scallop SMA large fenestraion RRA small fenestration LRA small fenestration Bifurcated endograft Vascular Surgery – University of Bologna

38 Fenestrated endograft Vascular Surgery – University of Bologna

39 Bone landmarks T12 Vascular Surgery – University of Bologna

40 L5 Bone landmarks Vascular Surgery – University of Bologna

41 Femoral Access Vascular Surgery – University of Bologna

42 Pre-operative C-Arm evaluation. Vascular Surgery – University of Bologna

43 . 20° Pre-operative C-Arm evaluation Vascular Surgery – University of Bologna

44 . 90° Pre-operative C-Arm evaluation Vascular Surgery – University of Bologna

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