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Endovascular techniques for arch vessel reconstruction

Published byΠύθιος Βιλαέτης Modified over 5 years ago

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Presentation on theme: "Endovascular techniques for arch vessel reconstruction"— Presentation transcript:

1 Endovascular techniques for arch vessel reconstruction
G. Matthew Longo, MD, Iraklis I. Pipinos, MD  Journal of Vascular Surgery  Volume 52, Issue 4, Pages 77S-81S (October 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 A, Stent graft positioned, with needle and sheath position against the graft, and the graft is punctured. B, Wire is advanced into the lumen of the graft. C, Balloons are passed into the fenestration and used to serially dilate the puncture site. D, The inch wire is exchanged for a stiff inch wire, and the sheath is advanced across the fenestration with the stent. E, The stent is deployed and flared proximally and distally. Journal of Vascular Surgery  , 77S-81SDOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Modified transjugular intrahepatic portosystemic shunt sheath, with an inner metal core is pre-molded to allow safe passage of the long needle to the thoracic graft. Reprinted with permission from Manning BJ, et al. J Vasc Surg 2010;52:491-4. Journal of Vascular Surgery  , 77S-81SDOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

4 Fig 3 A, Sheath is advanced along the lateral edge of the thoracic graft. B, Balloon-expandable stent is placed to restore perfusion to the covered vessel. C and D, Retrograde stenting of the left subclavian artery origin via the transbrachial approach. Journal of Vascular Surgery  , 77S-81SDOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

5 Fig 4 A, Carotid-carotid bypass and subclavian-carotid reimplantion. B, Insertion of first sheath. C, Deployment of bifurcated proximal component, proximal stent. D, Deployment of bifurcated proximal component, short aortic limb. E, Catheterization of bifurcated proximal component. F, Insertion of second sheath. G, Deployment of tubular distal component. H, Ligation of left common carotid artery. Reprinted with permission from Chuter TAM, et al. J Vasc Surg 2003;38: Journal of Vascular Surgery  , 77S-81SDOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

6 Fig 5 A, Arch arteriogram demonstrating a saccular pseudoaneurysm. B, Completion angiogram, demonstrating proper graft placement and perfusion of all brachiocephalic arteries. C, Postoperative CT angiogram. Reprinted with permission from Schneider DB, et al. J Vasc Surg 2003;38:855. Journal of Vascular Surgery  , 77S-81SDOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

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