Abdominal aortic aneurysm - Endovascular therapy

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Bilateral exposure of the groin vessels
Insertion of sheaths
Placement of the stiff guidewire (from the left)
Placement of an angiography catheter (from the right)
Preparation of the main graft body
Insertion of the main prosthesis body (from the left)
Performing an overview angiography
Implantation of the main body of the prosthesis
Probing of the right iliac graft limb
Preparation of the iliac graft limb
Insertion of the iliac graft limb (right)
Implantation of the iliac graft limb (right)
Definitive deployment of the main graft body
Removal of the delivery system of the main graft body
Completion angiography
Performing an aneurysmography
Removal of the interventional material
Closure of the arteriotomy
Wound closure

Authors

Date

date of publication: 8 Nov 2011

surgery report

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Bilateral exposure of the groin vessels

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Longitudinal skin incision bilaterally in the inguinal crease and medial retraction of the lymphatic vessels, opening of the fascia lata, and slinging of the femoral artery with a tourniquet.
Insertion of sheaths

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Puncture of the common femoral artery with a hollow needle, insertion of a guidewire, and exchange of the needle for the sheath (1 x left, 2 x right).
Placement of the stiff guidewire (from the left)

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Advancing a hydrophilic (Terumo) wire via the left iliac arterial pathway into the thoracic aorta, over which a (multipurpose) catheter is then introduced; exchange of the hydrophilic wire for a stiff wire (Back-up Meier).
Placement of an angiography catheter (from the right)

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Probing of the pelvic vascular tree using a hydrophilic (Terumo) wire, over which an angiography catheter (pigtail) is advanced into the suprarenal aorta (approx. level L1); remove the wire.
Preparation of the main graft body

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Removal from the packaging, flushing with heparin saline solution, extracorporeal fluoroscopy.
Insertion of the main prosthesis body (from the left)

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Removal of the sheath while leaving the stiff guidewire in place, advancing the main prosthesis body over the stiff guidewire under fluoroscopy into the aorta while maintaining the correct rotational orientation.