Totally laparoscopic aortohepatic bypass for aortic debranching during endovascular thoracoabdominal aneurysm repair.
BACKGROUND
Endovascular grafting of the aorta is gaining widespread acceptance for treating aortic aneurysms. Para-renal aneurysms or thoraco-abdominal aneurysms may be a relative contra-indication for endovascular aneurysm repair (EVAR) unless visceral vessels can be debranched.


METHODS
We describe a case of thoraco-abdominal aneurysm extending from the descending thoracic aorta to the level of coeliac artery. A totally laparoscopic retrograde aorto-hepatic bypass was performed in conjunction with endograft exclusion of the aneurysm and coverage of the coeliac artery ostium.


CONCLUSIONS
Laparoscopic debranching of visceral vessels extends the indications of EVAR.
Bakoyiannis
C
C
Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital Düsseldorf FRG, Germany. bakogian@hotmail.com
Cagiannos
C
C
Wasilljew
S
S
Pinter
L
L
Kolvenbach
R
R
D000368:Aged; D000714:Anastomosis, Surgical; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006499:Hepatic Artery / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011474:Prosthesis Design; D015607:Stents