Hepatorenal bypass allowing fenestrated endovascular repair of juxtarenal abdominal aortic aneurysm: a case report.
A 61-year-old man presented with a 66-mm juxtarenal aortic aneurysm. He was unfit for open repair. The anatomical proximity of his right renal artery (RRA) and his superior mesenteric artery (SMA) precluded fabrication of an endograft allowing perfusion of both vessels. He underwent a hepato-renal bypass to his RRA and subsequent fenestrated endovascular aneurysm repair (EVAR) using an endoprosthesis with fenestrations for the SMA and the left renal artery (LRA), and a scallop for the coeliac trunk. Follow-up imaging showed all visceral vessels to be perfused. The use of this limited hybrid approach allows endovascular treatment of aneurysms that are initially unsuitable for such an approach.
Lerussi
G
G
Vascular Surgery, Hôpital Cardiologique, CHRU de Lille, Université Lille 2, 59037 Lille Cedex, France.
O'Brien
N
N
Sessa
C
C
D'Elia
P
P
Sobocinski
J
J
Perrot
C
C
Azzaoui
R
R
Haulon
S
S
D000714:Anastomosis, Surgical; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008875:Middle Aged; D011474:Prosthesis Design; D012039:Regional Blood Flow; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome