title: Hybrid treatment for juxtarenal aortic occlusion: successful revascularization using iliofemoral semiclosed endarterectomy and kissing-stents technique.
abstract: A 53-year-old man with a significant respiratory history waiting for lung transplantation presented with severe bilateral buttock and thigh claudication. Angiography revealed severe stenosis of the left renal artery and total occlusion of the infrarenal abdominal aorta and iliac vessels. Via a bilateral surgical femoral exposure, we performed semiclosed endarterectomy of the iliofemoral vessels and percutaneous transluminal angioplasty stenting of the infrarenal aorta with two Palmaz stents and percutaneous transluminal angioplasty "kissing stents" of the iliac arteries with three Luminexx stents bilaterally. Completion angiography showed successful complete recanalization of the aortoiliofemoral axis. Palpable distal pulses were restored. A combined surgical and endovascular approach should be considered a viable alternative to laparotomy in selected patients with total juxtarenal aortic occlusion.
authors.affiliation: Vascular Surgery, Department of Surgery, University of Insubria, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Castelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Caronno
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.forename: Matteo
authors.initials: M
authors.lastname: Tozzi
authors.forename: Chiara
authors.initials: C
authors.lastname: Lomazzi
authors.forename: Domenico
authors.initials: D
authors.lastname: Laganà
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Carrafiello
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cuffari
mesh_terms: D000792:Angiography; D000800:Angioplasty, Balloon; D001018:Aortic Diseases / Q000175:diagnosis / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004691:Endarterectomy; D005263:Femoral Artery; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D015607:Stents