Presentation is loading. Please wait.

Presentation is loading. Please wait.

David Nabi, MD, Erin H. Murphy, MD, Jimmy Pak, MD, Christopher K

Published byKadri Moor Modified over 5 years ago

Similar presentations

Presentation on theme: "David Nabi, MD, Erin H. Murphy, MD, Jimmy Pak, MD, Christopher K"— Presentation transcript:

1 Open surgical repair after failed endovascular aneurysm repair: Is endograft removal necessary? 
David Nabi, MD, Erin H. Murphy, MD, Jimmy Pak, MD, Christopher K. Zarins, MD  Journal of Vascular Surgery  Volume 50, Issue 4, Pages (October 2009) DOI: /j.jvs Copyright © 2009 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Aortic neck plication. A, A band of Dacron graft is placed circumferentially around the infrarenal aortic neck and (B) secured to itself with 4-0 polypropylene suture. C, The band is then serially tightened and secured with additional sutures until a tight band is formed around the exterior of the aorta, compressing it against the endograft. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Partial endograft preservation. A, The aneurysm is exposed, and a band of Teflon felt fabric is wrapped around the aortic neck. The aorta is then clamped and opened. B, The proximal attachments of the endograft are removed from the aorta, (C) and the proximal stent is resected. D, A bifurcated Dacron graft is anastomosed to the remaining portion of the stent graft. The aneurysm sac is then closed over the repair. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

4 Fig 3 The endograft main body or iliac limbs may be collapsed and inserted into the main body or iliac limbs of the Dacron surgical graft, respectively. A, The self-expanding nitinol stents (yellow arrow) of the endograft create an anastomotic seal. B, Several tacking sutures (blue arrow) are placed incorporating both the Dacron graft and distal endograft to ensure that there is no slippage of the junction. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

5 Fig 4 A, Preoperative image of the patient from Fig 1 shows a proximal type I endoleak (blue arrow) unamenable to endovascular intervention. The patient underwent conversion with creation of a proximal aortic wrap allowing complete endograft preservation. B, The postoperative image demonstrates recreation of the proximal endograft seal by the aortic wrap (yellow arrow) and elimination of endoleak. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Computed tomography (CT) scans of the same patient (A) before initial endovascular aneurysm repair (EVAR) and (B) after initial EVAR. Note on image (B) that while iliac fixation is maintained, there is a persistent type 1 endoleak associated with an angulated, reverse-funnel neck. On the CT scan image to the far right (C), completed after time of delayed conversion to open repair, note the absence of endoleak and preservation of the distal endograft. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Download ppt "David Nabi, MD, Erin H. Murphy, MD, Jimmy Pak, MD, Christopher K"

Similar presentations

Endoleak after endovascular aneurysm repair: Duplex ultrasound imaging is better than computed tomography at determining the need for intervention  Greg.

Endoleak after endovascular aneurysm repair: Duplex ultrasound imaging is better than computed tomography at determining the need for intervention  Greg.
Yehuda G. Wolf, MD, Bradley B. Hill, MD, W

Yehuda G. Wolf, MD, Bradley B. Hill, MD, W
The value of the initial post-EVAR computed tomography angiography scan in predicting future secondary procedures using the Powerlink stent graft  Mitul.

The value of the initial post-EVAR computed tomography angiography scan in predicting future secondary procedures using the Powerlink stent graft  Mitul.
Progressive growth of a pelvic collection five years after endovascular aneurysm repair: An atypical presentation of an asymptomatic contained rupture 

Progressive growth of a pelvic collection five years after endovascular aneurysm repair: An atypical presentation of an asymptomatic contained rupture 
Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD 

Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD 
Lee J. Goldstein, MD, Combiz Rezayat, MD, Gautam V

Lee J. Goldstein, MD, Combiz Rezayat, MD, Gautam V
Victor J. Davila, MD, William Stone, MD, Audra A

Victor J. Davila, MD, William Stone, MD, Audra A
The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture  Felix J.V. Schlösser, MD, PhD, John E. Aruny,

The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture  Felix J.V. Schlösser, MD, PhD, John E. Aruny,
A new technique for reconstruction of the aortic bifurcation with saphenous vein panel graft  Alexandros Mallios, MD, Benoit Boura, MD, Faris Alomran,

A new technique for reconstruction of the aortic bifurcation with saphenous vein panel graft  Alexandros Mallios, MD, Benoit Boura, MD, Faris Alomran,
Hari R. Kumar, MD, Mark K. Eskandari, MD 

Hari R. Kumar, MD, Mark K. Eskandari, MD 
A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after.

A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after.
Aortoduodenal fistula 5 years after endovascular abdominal aortic aneurysm repair with the Ancure stent graft  Blaine J. Ruby, MD, Thomas H. Cogbill,

Aortoduodenal fistula 5 years after endovascular abdominal aortic aneurysm repair with the Ancure stent graft  Blaine J. Ruby, MD, Thomas H. Cogbill,
Clinical outcomes for endovascular repair of abdominal aortic aneurysm with the Seal stent graft  Jeong Ho Kim, MD, Young Kwon Cho, MD, Tae-Seok Seo,

Clinical outcomes for endovascular repair of abdominal aortic aneurysm with the Seal stent graft  Jeong Ho Kim, MD, Young Kwon Cho, MD, Tae-Seok Seo,
Aortic neck enlargement after endovascular aneurysm repair using balloon-expandable versus self-expanding endografts  Janis Savlovskis, MD, Dainis Krievins,

Aortic neck enlargement after endovascular aneurysm repair using balloon-expandable versus self-expanding endografts  Janis Savlovskis, MD, Dainis Krievins,
Combined surgical and endovascular treatment of aortic arch aneurysms

Combined surgical and endovascular treatment of aortic arch aneurysms
Visceral embolus protection by catheters with balloon-inflatable tips during hybrid repair of thoracoabdominal aortic aneurysm  Mojtaba Sadeghi-Azandaryani,

Visceral embolus protection by catheters with balloon-inflatable tips during hybrid repair of thoracoabdominal aortic aneurysm  Mojtaba Sadeghi-Azandaryani,
Peyman Benharash, MD, Jason T. Lee, MD, Oscar J

Peyman Benharash, MD, Jason T. Lee, MD, Oscar J
Novel technique for endovascular salvage of a folded aortic endograft

Novel technique for endovascular salvage of a folded aortic endograft
Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD 

Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD 
Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms  Jared Kray, DO, Spencer Kirk, DO, Jan Franko,

Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms  Jared Kray, DO, Spencer Kirk, DO, Jan Franko,

Similar presentations

Ads by Google