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Treatment of chronic expanding dissecting aneurysms of the descending thoracic and upper abdominal aorta by extended aortotomy, removal of the dissected.

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Presentation on theme: "Treatment of chronic expanding dissecting aneurysms of the descending thoracic and upper abdominal aorta by extended aortotomy, removal of the dissected."— Presentation transcript:

1 Treatment of chronic expanding dissecting aneurysms of the descending thoracic and upper abdominal aorta by extended aortotomy, removal of the dissected intima, and closure  G.Melville Williams, MD  Journal of Vascular Surgery  Volume 18, Issue 3, Pages (September 1993) DOI: / (93)90262-K Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Extraperitoneal exposure of segment 2. Left kidney and peritoneal contents are displaced anteriorly, allowing full exposure to open aorta through false channel that supplies left kidney. Lower cross-section insert shows how “true” lumen is entered through one of several perforations or entry points connecting two lumina. Journal of Vascular Surgery  , DOI: ( / (93)90262-K) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 True lumen has been incised longitudinally and excess intima is trimmed away. Tailored segment can be closed to normal size. Journal of Vascular Surgery  , DOI: ( / (93)90262-K) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 CT scan at 4½ years at level of celiac axis, which is in middle of tailored segment. Note round aortic lumen with normal origin of celiac axis. Journal of Vascular Surgery  , DOI: ( / (93)90262-K) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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