title: "Cracking and paving": a novel technique to deliver a thoracic endograft despite ilio-femoral occlusive disease.
abstract: BACKGROUND
  The use of endoluminal grafts to treat thoracic aortic aneurysms has been associated with a decreased morbidity and mortality compared with open thoracic aortic aneurysm repair. High-risk surgical patients with ilio-femoral occlusive disease may not be amenable to general anesthesia and the construction of a retroperitoneal conduit.
  
  
  RESULTS
  We report the use of a novel technique consisting of cracking and paving of the ilio-femoral vessels with balloon angioplasty, followed by deployment of an endoconduit to deliver an endoluminal graft under local sedation to treat a high-risk 80-year-old patient with a thoracic aneurysm.
  
  
  CONCLUSIONS
  High-risk surgical patients with iliofemoral disease can undergo endoluminal graft therapy to threat thoracic aortic aneurysms.
authors.affiliation: Division of Cardiac Surgery, North Western Memorial Hospital, Chicago, Illinois, USA. jkpodonu@yahoo.com
authors.forename: Jacques
authors.initials: J
authors.lastname: Kpodonu
authors.forename: Julio A
authors.initials: JA
authors.lastname: Rodriguez-Lopez
authors.forename: Venkatesh G
authors.initials: VG
authors.lastname: Ramaiah
authors.forename: Edward B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000473:pathology / Q000601:surgery*