Safe and fast proximal aortic control using an aortic balloon through direct graft puncture for the explantation of an abdominal endograft with suprarenal fixation.
The late removal of an abdominal aortic endograft is technically challenging and can be associated with significant blood loss, especially when a graft with active suprarenal fixation is involved. The main issue in safe explantation of the endograft is control of the aorta above the proximal fixation site. We report an adjunctive technique for the safe and fast proximal control of the suprarenal aorta using an aortic balloon. The endograft is directly punctured and an aortic balloon is deployed and inflated above the fixation site in the supracoeliac aorta. The time for supracoeliac control in our 2 patients was <5 min. This simple technique offers a safe and fast aortic control during the removal of the endograft, especially when active suprarenal fixation is used, avoiding the risks from a technically demanding dissection in a potentially inflammatory region.
Department of Surgery, Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece.
Miltiadis
M
Matsagkas
George N
GN
Kouvelos
Michalis
M
Peroulis
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001027:Aortography / Q000379:methods; D021721:Balloon Occlusion; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D020878:Device Removal / Q000379:methods*; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011677:Punctures; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Endovascular aortic aneurysm repair; Graft explantation; Open conversion; Suprarenal fixation