Sutureless telescoping aortic anastomotic technique for hybrid surgical treatment of aortoiliac occlusive disease.
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.
Donas
Konstantinos P
KP
Clinic for Cardiovascular Surgery and, University Hospital of Zurich, Switzerland.
Rancic
Zoran
Z
Frauenfelder
Thomas
T
Ueda
Hideki
H
Lachat
Mario
M
Veith
Frank J
FJ
Mayer
Dieter
D
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