title: Sutureless telescoping aortic anastomotic technique for hybrid surgical treatment of aortoiliac occlusive disease.
abstract: OBJECTIVE
  To describe a new technique to assist aortoiliac stent-graft implantation in the presence of severe and extensive calcification.
  
  
  METHODS
  The use of an aortic stent-graft telescoped into the aorta and deployed partly within and partly outside the aorta is illustrated in 2 cases. In the first, the bifurcated stent-graft was deployed with the proximal end and body intraluminally within the aorta; the distal ends (legs) were extended in an extravascular fashion with surgical grafts to reach the femoral bifurcation. In the second case, a tapered tubular stent-graft was deployed through the aortic wall to land partially inside the aortic lumen and partly inside a bifurcated standard surgical graft; the distal ends of the surgical graft were anastomosed to the iliac arteries by a standard anastomosis on the left and by an intraluminal telescoped stent-graft anastomosis on the right. Follow-up was uneventful in both patients. The sutureless telescoping anastomosis was stable at 5 years and 6 months, respectively, on computed tomographic angiography.
  
  
  CONCLUSIONS
  These favorable outcomes underscore that this technique should be considered in patients with aortoiliac occlusive disease in whom aortic cross-clamping and/or a standard aortic anastomosis is expected to be difficult or impossible.
authors.affiliation: Clinic for Cardiovascular Surgery and, University Hospital of Zurich, Switzerland.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
authors.forename: Zoran
authors.initials: Z
authors.lastname: Rancic
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueda
authors.forename: Mario
authors.initials: M
authors.lastname: Lachat
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D015607:Stents; D013536:Suture Techniques