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Thoraco-Abdominal Aneurysms Endovascular Approach

Thoraco-Abdominal Aneurysms Endovascular Approach. Chirurgie Vasculaire - Hôpital Cardiologique CHRU de Lille - France. HYBRID PROCEDURES. CONCEPT. Endovascular repair of complex aortic aneurysms involving : Visceral vessels (juxtarenal, pararenal, TAAA) Both common iliac arteries. CONCEPT.

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Thoraco-Abdominal Aneurysms Endovascular Approach

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  1. Thoraco-Abdominal AneurysmsEndovascular Approach Chirurgie Vasculaire - Hôpital Cardiologique CHRU de Lille - France

  2. HYBRID PROCEDURES

  3. CONCEPT • Endovascular repair of complex aortic aneurysms involving : • Visceral vessels (juxtarenal, pararenal, TAAA) • Both common iliac arteries

  4. CONCEPT • Sealing zones determined on pre operative CT = length of aorta to be covered • Endograft designed with fenestrations and / or branches to perfuse vessels covered by fabric

  5. Endovascular Options to Perfuse Target Vessels • REINFORCED FENESTRATIONS

  6. BRANCHES

  7. PRELOADED CATHETER

  8. Bridging Stentgraft

  9. SIZING: 3D-Volume Rendering

  10. Bone Removal

  11. CPR

  12. LEFT RENAL at 2.45

  13. Short neck AAA,Juxta and Pararenal Aneurysms

  14. PROCEDURE

  15. POST-OPERATIVE CT

  16. Type IV TAAA

  17. ANGULATION OF AORTIC BRANCHES

  18. Contemporary Retrospective Comparative Analysis Greenberg R, Lu Q, et al, Circ In Press 2008 • Consecutive elective TAAA repair over 5 years • Retrospective review • All films pre and post procedure evaluated • All patients classified using identical criteria • Outcomes evaluated • 30 day mortality • 12 month survival • Paraplegia • Timing • Severity

  19. Comparison of Patients (N=734) SR (n=372) ER (n=352)

  20. Paraplegia Greenberg R, Lu Q, et al, Circ In Press 2008

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