A laparoscopic approach to the abdominal aorta for thoracic stent-graft deployment: evaluation in a porcine model
| Autor: | Maxime Formichi, Jean-François Renier |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Swine
Blood Loss Surgical 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging Catheterization 03 medical and health sciences Blood Vessel Prosthesis Implantation surgical procedures operative 0302 clinical medicine cardiovascular system Animals Minimally Invasive Surgical Procedures Radiology Nuclear Medicine and imaging Surgery Laparoscopy Stents Aorta Abdominal Cardiology and Cardiovascular Medicine Intraoperative Complications |
| Zdroj: | Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 9(3) |
| ISSN: | 1526-6028 |
| Popis: | Purpose: To develop laparoscopic techniques for aortic stent-graft placement as an alternative to the femoral approach. Methods: Endovascular stent-grafts were placed in 8 pigs via a totally laparoscopic retroperitoneal approach. After needle puncture, a guidewire was inserted into the abdominal aorta, followed by an 18-F sheath through which a Talent stent-graft was deployed in the descending thoracic aorta without aortic clamping. All the endovascular tools were inserted into the retroperitoneal area via the ports. After the sheath was withdrawn, hemostasis was achieved by suturing the aortic puncture under aortic cross-clamping. After sacrificing the animals, the thoracic aorta was removed to verify the position and deployment of the stent-grafts. Results: Seven (87.5%) of 8 procedures were successfully completed; the first animal died from hemorrhage due to inadvertent injury to the posterior infrarenal aortic wall. The accurate deployment and position of the stent-grafts were verified visually after sacrifice. Mean (± SD) procedural, implantation, and aortic cross-clamping times were 205 ± 56, 22 ± 9, and 30 ± 19 minutes, respectively. Mean blood loss was 120 ± 56 mL. Conclusions: Thoracic aortic stent-grafting using a laparoscopic approach to the infrarenal aorta is feasible. More studies will be required to define the place of combined endovascular and laparoscopic procedures as an alternative to the femoral surgical approach for stent-graft placement. |
| Databáze: | OpenAIRE |
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