ArticleJournal of vascular surgery cases and innovative techniques2021
A hybrid clampless technique for aortic anastomoses.
Article in Journal of vascular surgery cases and innovative techniques, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors at 2 institutions in 1 country.
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Abstract
background and purposeIn various circumstances of aortic repairs (heavy circumferential calcifications or shaggy aorta with extensive thrombus), open and endovascular techniques are at high risk. In addition to a likelihood of emboli, aortic clamping can be complicated by rupture and endovascular techniques may not be successful. We here describe a simple and reproducible hybrid technique that allows performing an aortic anastomosis without clamping in these situations.
methodsAfter a limited exposure of the anterior aortic wall in a healthy segment, a prosthetic graft is sutured without any arteriotomy or clamping (adventitial suture), mimicking the final aspect of an end-to-side anastomosis. The graft and the anastomosis site are punctured using a long needle, allowing a guidewire to be positioned in the aorta under fluoroscopic guidance. Protected covered stenting of the anastomosis site opens the anastomosis without aortic clamping. After tunneling the graft to the target artery, the distal anastomosis is performed in a usual fashion.
resultsThis technique was successfully used in 10 challenging consecutive cases with a sustained patency.
conclusionsThis hybrid clampless technique for aortic anastomosis represents a useful alternative for challenging lesions unsuitable for a simple open or endovascular treatment.
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