A total laparoscopic technique for endovascular thoracic stent graft deployment

Abstract

Totally laparoscopic assisted graft implantation in aorta or iliac arteries provides a safe and effective access for the endovascular delivery system. However, further evaluation and long follow-up are necessary to ensure the potential advantages of this technique. It is a less invasive option to overcome access-related problems with thoracic endograft deployment, giving the patient the advantage of a totally minimal invasive procedure.

Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

“…Common causes of aortic access difficulties include iliac arteries with naturally small calibers or that have narrowed because of extensive atherosclerosis or calcifications. Certain options have been developed over the years in attempts to surmount these difficulties, including intra-abdominal tunnels or conduits; 6 retroperitoneal conduits; 7 conduits constructed with the aid of video vascular surgery; 8 iliac reconstruction surgeries or bypasses, 9 and angioplasty of the iliac arteries with or without stents. 10 Iliofemoral endarterectomy, 1 dissection and direct puncture of the aortoiliac segment, 9,11 and utilization of internal conduits 2,3,12 have also been described.…”

“…Employing videolaparoscopy during construction of the conduit offers the advantage of being much less invasive, but demands a long learning curve and a team trained to conduct the procedure. 8 Angioplasties of the iliac arteries, with or without stents, have also been proposed in attempts Final control for EVAR. The decision was taken not to use the proximal extension to the endoprosthesis, since there was total exclusion of the aneurysm with the onepiece bifurcated endoprosthesis.…”