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Endoluminal repair of atypical dissecting aneurysm of descending thoracic aorta and fusiform aneurysm of the abdominal aorta  James May, MS, FRACS, Geoffrey.

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Presentation on theme: "Endoluminal repair of atypical dissecting aneurysm of descending thoracic aorta and fusiform aneurysm of the abdominal aorta  James May, MS, FRACS, Geoffrey."— Presentation transcript:

1 Endoluminal repair of atypical dissecting aneurysm of descending thoracic aorta and fusiform aneurysm of the abdominal aorta  James May, MS, FRACS, Geoffrey White, FRACS, Weiyun Yu, BSc (Med), MB, BS, Toos Sachinwalla, FRACR, Timothy McGahan, FRACS, Gregory Monaghan, FRACS  Journal of Vascular Surgery  Volume 22, Issue 2, Pages (August 1995) DOI: /S (95) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Saggital projection of gradient-recalled echo MRI sequence demonstrates bright flowing blood in true lumen and bright signal in false lumen (arrow) consistent with methemoglobin in false lumen of aortic dissection. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 T1-weighted transverse MRI image through thoracic aorta demonstrates high signal consistent with methemoglobin in thrombosed false lumen of dissected descending thoracic aorta (arrow). Note no ascending aortic component is present. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 Sagittal T1-weighted image demonstrates thrombosed false lumen (arrow) with predominately bright signal extending inferiorly into infrarenal AAA. A represents lumen of AAA. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 4 Postcontrast CT (in craniocaudal direction) demonstrates AAA (T represents true lumen) with separate opacified posterior sac (F represents opacified false lumen) continuous with thrombosed false lumen (A) extending superiorly in dissected portions of aorta. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 4 Postcontrast CT (in craniocaudal direction) demonstrates AAA (T represents true lumen) with separate opacified posterior sac (F represents opacified false lumen) continuous with thrombosed false lumen (A) extending superiorly in dissected portions of aorta. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

7 Fig. 4 Postcontrast CT (in craniocaudal direction) demonstrates AAA (T represents true lumen) with separate opacified posterior sac (F represents opacified false lumen) continuous with thrombosed false lumen (A) extending superiorly in dissected portions of aorta. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

8 Fig. 4 Postcontrast CT (in craniocaudal direction) demonstrates AAA (T represents true lumen) with separate opacified posterior sac (F represents opacified false lumen) continuous with thrombosed false lumen (A) extending superiorly in dissected portions of aorta. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

9 Fig. 4 Postcontrast CT (in craniocaudal direction) demonstrates AAA (T represents true lumen) with separate opacified posterior sac (F represents opacified false lumen) continuous with thrombosed false lumen (A) extending superiorly in dissected portions of aorta. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

10 Fig. 4 Postcontrast CT (in craniocaudal direction) demonstrates AAA (T represents true lumen) with separate opacified posterior sac (F represents opacified false lumen) continuous with thrombosed false lumen (A) extending superiorly in dissected portions of aorta. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

11 Fig. 5 Lateral abdominal aortogram demonstrates AAA with separate sac (F) filling posteriorly. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

12 Fig. 6 Aortogram of infrarenal AAA. Note that aneurysm lacks distal neck and is unsuitable for endoluminal tube graft. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

13 Fig. 7 Postoperative aortogram demonstrates normal flow through aorta and endograft without leak of contrast agent into aneurysmal sac. Note ligated right common iliac artery. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

14 Fig. 8 Diagram demonstrates method of repair. Restoration of blood flow to lower extremities has been achieved through extraperitoneal bifurcated Dacron graft sutured proximally to coaxial Dacron conduit and endoluminal aortoiliac endograft. Only two of five metal attachment devices are shown for clarity. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

15 Fig. 9 A, Contrast CT section obtained 6 months after operation in region of previously present opacifying sac demonstrated in Fig. 4 with endograft in place, demonstrating that sac no longer fills. B, Contrast CT section obtained 6 months after operation just above endograft demonstrates false lumen is no longer evident. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

16 Fig. 9 A, Contrast CT section obtained 6 months after operation in region of previously present opacifying sac demonstrated in Fig. 4 with endograft in place, demonstrating that sac no longer fills. B, Contrast CT section obtained 6 months after operation just above endograft demonstrates false lumen is no longer evident. Journal of Vascular Surgery  , DOI: ( /S (95) ) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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