A hybrid approach to recanalization of a chronic iliofemoral occlusion

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Presentation transcript:

A hybrid approach to recanalization of a chronic iliofemoral occlusion Sadaf Sadie Ahanchi, MD, Jean Michel Panneton, MD, Christopher Lee Stout, MD Journal of Vascular Surgery Volume 57, Issue 1, Pages 230-233 (January 2013) DOI: 10.1016/j.jvs.2012.07.046 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 a, A preoperative angiogram demonstrates patency of previous left iliac stenting and occlusion of the right ileofemoral system. b, Preoperative ankle-brachial index (ABI) shows monophasic right femoral, popliteal, and pedal waveforms, with an ABI of 0.24 on the right. c, A preoperative computed tomography angiography (CTA) demonstrates patency of previous left iliac stenting and occlusion of right iliofemoral system, with reconstitution of superficial femoral artery (SFA) and profunda femoral artery (PFA). Journal of Vascular Surgery 2013 57, 230-233DOI: (10.1016/j.jvs.2012.07.046) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 a, In this schematic of a hybrid iliofemoral bypass, the arrow depicts the distal external iliac artery (EIA). b, Schematic depicts the anastomosis of the Viabahn to bovine patch angioplasty of the profunda femoral artery (PFA) and superficial femoral artery (SFA) confluence. c, Operative photograph shows the final Viabahn-to-vein patch anastomosis. d, Completion angiograms show patency of the proximal portion of the right hybrid ileofemoral bypass and patency of the anastomosis onto the SFA and PFA. Journal of Vascular Surgery 2013 57, 230-233DOI: (10.1016/j.jvs.2012.07.046) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 a, A computed tomography angiography (CTA) demonstrates bilateral patency of ileofemoral segments. b, Postoperative ankle-brachial index (ABI) demonstrates improvement on the right to 0.72 with multiphasic pedal waveforms. Journal of Vascular Surgery 2013 57, 230-233DOI: (10.1016/j.jvs.2012.07.046) Copyright © 2013 Society for Vascular Surgery Terms and Conditions