Back-Table Surgeon Modification of a t-Branch
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Back-Table Surgeon Modification of a t-Branch. / Scheerbaum, Martin; Kölbel, Tilo; Rohlffs, Fiona; Heidemann, Franziska; Debus, Sebastian E; Tsilimparis, Nikolaos.
In: ANN VASC SURG, Vol. 45, 11.2017, p. 330-335.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Back-Table Surgeon Modification of a t-Branch
AU - Scheerbaum, Martin
AU - Kölbel, Tilo
AU - Rohlffs, Fiona
AU - Heidemann, Franziska
AU - Debus, Sebastian E
AU - Tsilimparis, Nikolaos
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/11
Y1 - 2017/11
N2 - BACKGROUND: Surgeon modification of commercially available aortic stent grafts represents a salvage option to treat complex aortic pathologies in high-risk patients.TECHNIQUE: A 68-year-old male was referred to our hospital with a contained rupture of the visceral aorta. The patient was previously treated with an infrarenal tube graft 16 years earlier as well as with a Crawford procedure with island patch of the celiac trunk (TC) and the superior mesenteric artery (SMA) and bypasses to both renal arteries 6 years before admission. The computed tomography demonstrated a "blowout aneurysm" of the TC and SMA patch. The bypass to the left renal artery originated from the level of the TC. We therefore modified a commercially available t-branch (Cook® Medical, Bloomington, IN) with surgeon-made fenestrations for both renal arteries. The procedure was successful, and the patient could be discharged to home on the seventh postoperative day.CONCLUSIONS: The use of surgeon-modified "off-the-shelf" t-branches broadens the possibilities of treating even anatomically very challenging aortic pathologies otherwise not suitable for the t-branch.
AB - BACKGROUND: Surgeon modification of commercially available aortic stent grafts represents a salvage option to treat complex aortic pathologies in high-risk patients.TECHNIQUE: A 68-year-old male was referred to our hospital with a contained rupture of the visceral aorta. The patient was previously treated with an infrarenal tube graft 16 years earlier as well as with a Crawford procedure with island patch of the celiac trunk (TC) and the superior mesenteric artery (SMA) and bypasses to both renal arteries 6 years before admission. The computed tomography demonstrated a "blowout aneurysm" of the TC and SMA patch. The bypass to the left renal artery originated from the level of the TC. We therefore modified a commercially available t-branch (Cook® Medical, Bloomington, IN) with surgeon-made fenestrations for both renal arteries. The procedure was successful, and the patient could be discharged to home on the seventh postoperative day.CONCLUSIONS: The use of surgeon-modified "off-the-shelf" t-branches broadens the possibilities of treating even anatomically very challenging aortic pathologies otherwise not suitable for the t-branch.
KW - Aged
KW - Aortic Aneurysm/drug therapy
KW - Aortic Rupture/diagnostic imaging
KW - Aortography/methods
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/instrumentation
KW - Computed Tomography Angiography
KW - Humans
KW - Male
KW - Prosthesis Design
KW - Stents
KW - Surgeons
KW - Treatment Outcome
U2 - 10.1016/j.avsg.2017.07.011
DO - 10.1016/j.avsg.2017.07.011
M3 - SCORING: Journal article
C2 - 28739468
VL - 45
SP - 330
EP - 335
JO - ANN VASC SURG
JF - ANN VASC SURG
SN - 0890-5096
ER -
