Common Iliac Artery Access during Endovascular Thoracic Aortic Repair Facilitated by a Transabdominal Wall Tunnel
Autor: | Richard D. Edwards, Paul Rogers, Jonathan Moss, Sumaira Macdonald, D. S. Byrne |
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Rok vydání: | 2001 |
Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.medical_treatment Aorta Thoracic Arteriotomy 030204 cardiovascular system & hematology Iliac Artery 030218 nuclear medicine & medical imaging Abdominal wall 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Humans Retroperitoneal space Thoracic aorta Radiology Nuclear Medicine and imaging Abdominal Muscles Aorta business.industry External iliac artery musculoskeletal system Cannula Common iliac artery Surgery medicine.anatomical_structure Radiology Cardiology and Cardiovascular Medicine business Vascular Surgical Procedures |
Zdroj: | Journal of Endovascular Therapy. 8:135-138 |
ISSN: | 1545-1550 1526-6028 |
DOI: | 10.1177/152660280100800206 |
Popis: | Purpose: To describe a technique for common iliac artery (CIA) access during endovascular aortic aneurysm repair when unfavorable angulation between the CIA and the delivery sheath precludes direct arterial access. Technique: After retroperitoneal exposure of the CIA, a puncture site is chosen inferolateral to the surgical incision, and an 18-G trocar/cannula is advanced in alignment with the CIA through the anterior abdominal wall or skin of the upper thigh into the retroperitoneal space. Serial dilatation is performed over a guidewire placed through the cannula to create the subcutaneous tract. The trocar/cannula is replaced over the wire, and the CIA is punctured under direct vision. The guidewire is then advanced into the proximal aorta. A CIA arteriotomy is performed and the delivery system introduced over the guidewire through the tunnel into the iliac artery. Conclusions: Retroperitoneal exposure of the CIA with tunneled transabdominal wall delivery of the stent-graft avoids both external iliac artery injury and creation of a temporary access conduit in patients with iliac tortuosity and/or occlusive disease. |
Databáze: | OpenAIRE |
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