title: Crossing the limbs: a useful adjunct for successful deployment of the AneuRx stent-graft.
abstract: OBJECTIVE
  To describe a technique for deploying an AneuRx stent-graft in an abdominal aortic aneurysm (AAA) with an acutely angled aortic neck.
  
  
  METHODS
  In routine cases, the AneuRx stent-graft main body is positioned with the nose cone notch facing the contralateral side. In severely angulated aortic necks, however, the main body of the AneuRx stent-graft can be positioned with the nose cone notch and iliac limb gate facing the ipsilateral side; this dramatically reduces the acuity of the angle at the aortic neck and the iliac gate. This technique of "crossing the limbs" has been successfully used in 7 cases since FDA approval of the AneuRx device.
  
  
  CONCLUSIONS
  Proximal neck angulation is an important factor for successful endovascular AAA repair. Crossing the graft limbs reduces the effect of neck angulation on the proximal main body and may decrease the stress upon the contralateral limb gate, which may avoid graft gate disconnection and endoleak.
authors.affiliation: Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Arizona Heart Hospital, Phoenix, Arizona 85006, USA. vramaiah@azheart.com
authors.forename: Venkatesh G
authors.initials: VG
authors.lastname: Ramaiah
authors.forename: Charles S
authors.initials: CS
authors.lastname: Thompson
authors.forename: Shoaib
authors.initials: S
authors.lastname: Shafique
authors.forename: Julio A
authors.initials: JA
authors.lastname: Rodriguez
authors.forename: Rajagopalan
authors.initials: R
authors.lastname: Ravi
authors.forename: Leanne
authors.initials: L
authors.lastname: DiMugno
authors.forename: Edward B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D015607:Stents