title: Technique of supraceliac balloon control of the aorta during endovascular repair of ruptured abdominal aortic aneurysms.
abstract: Endovascular aneurysm repair is being used increasingly to treat ruptured abdominal aortic aneurysms (RAAAs). Approximately 25% of RAAAs undergo complete circulatory collapse before or during the procedure. Patient survival depends on obtaining and maintaining supraceliac balloon control until the endograft is fully deployed. This is accomplished with a sheath-supported compliant balloon inserted via the groin contralateral to the side to be used for insertion of the endograft main body. After the main body is fully deployed, a second balloon is placed within the endograft, and the first balloon is removed so that extension limbs can be placed in the contralateral side. A third balloon can be placed via the contralateral side and ipsilateral extensions deployed as necessary. This technique of supraceliac balloon control is important to achieving good outcomes with RAAAs. In addition to minimizing blood loss, this technique minimizes visceral ischemia and maintains aortic control until the aneurysm rupture site is fully excluded.
authors.affiliation: Division of Vascular Surgery, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: Todd L
authors.initials: TL
authors.lastname: Berland
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
authors.forename: Neal S
authors.initials: NS
authors.lastname: Cayne
authors.forename: Manish
authors.initials: M
authors.lastname: Mehta
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
authors.forename: Mario
authors.initials: M
authors.lastname: Lachat
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D001027:Aortography; D021721:Balloon Occlusion / Q000295:instrumentation; D019917:Blood Vessel Prosthesis Implantation; D057785:Catheters; D057510:Endovascular Procedures; D006439:Hemodynamics; D006801:Humans; D016896:Treatment Outcome