Modification of the Viabahn Padova sutureless technique for challenging anastomosis between a prosthetic graft and a circumferentially calcified target artery
| Autor: | Paolo Frigatti, Stefano Bonvini, Mirko Menegolo, Michele Piazza, Franco Grego, Luca Ferretto, II Joseph J. Ricotta |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Prosthetic graft medicine.medical_treatment Arterial Occlusive Diseases Femoral artery Constriction Pathologic Anastomosis Prosthesis Design chemistry.chemical_compound Blood Vessel Prosthesis Implantation medicine.artery Occlusion medicine Humans Radiology Nuclear Medicine and imaging Popliteal Artery Vascular Calcification Polytetrafluoroethylene Aged business.industry Endovascular Procedures Suture Techniques Stent Anatomy Popliteal artery Surgery Blood Vessel Prosthesis Femoral Artery Radiography surgical procedures operative medicine.anatomical_structure Treatment Outcome chemistry Stents Cardiology and Cardiovascular Medicine business Angioplasty Balloon Artery |
| Zdroj: | Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 19(3) |
| ISSN: | 1545-1550 |
| Popis: | PURPOSE To describe modification of the Viabahn Padova Sutureless (ViPS) technique for challenging anastomosis between a prosthetic graft and a circumferentially calcified target artery. TECHNIQUE The technique is demonstrated in a 75-year-old man with complete superficial femoral artery (SFA) occlusion and reconstitution of a circumferentially calcified above-knee popliteal artery. A 7-mm Viabahn endoprosthesis with its constraining string was withdrawn from its delivery system; the string at the proximal edge of the stent was gently cut with a scalpel, causing the proximal part of the stent to deploy, while the undeployed distal tip with its smooth profile retained its commercial orientation. The proximal end was subsequently sutured to a 7-mm polytetrafluoroethylene (PTFE) graft. After surgical exposure, the popliteal artery was transected, and the undeployed distal portion of the Viabahn was inserted into the distal segment, supported by a stiff guidewire. By pulling the constraining string, the stent was deployed in a "non-reversed" fashion and subsequently dilated to achieve optimal apposition. Finally, the proximal end of the PTFE graft was tunneled under the sartorius muscle and sutured to the common femoral artery. CONCLUSION This modification to the ViPS technique using a "non-reversed" method of Viabahn stent preparation allows a safer and more accurate deployment of the endoprosthesis in the calcified target artery. |
| Databáze: | OpenAIRE |
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