Snorkel Technique for Inferior Mesenteric Artery During Endovascular Repair of Abdominal Aortic Aneurysm

2018 ◽  
Vol 52 (3) ◽  
pp. 233-236
Author(s):  
Serkan Ertugay ◽  
Ahmet Daylan ◽  
Halil Bozkaya ◽  
Emrah Oğuz ◽  
Anıl Apaydın ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Renal Arteries ◽  
Main Body ◽  
Maximal Diameter ◽  
Abdominal Aortic

Purpose: The snorkel technique is commonly used to preserve renal arteries in juxta renal aneurysm during endovascular repair. Herein, we present a patient who underwent bifurcated endograft implantation with snorkel technique for inferior mesenteric artery (IMA) in order to preserve the major source of bowel circulation. Case Report: A 69-year-old male patient was diagnosed with abdominal aortic aneurysm. His history revealed that he had bowel resection due to a car accident 30 years ago. In addition, he was given relaparotomy 4 times due to intestinal complications. Computed tomography showed fusiform aneurysm with a maximal diameter of 60 mm and chronical occlusion of the superior mesenteric artery. Inferior mesenteric artery was found to be hypertrophic. During EVAR, 6 mm × 10 cm covered VIABAHN Endoprosthesis (Gore Medical) was implanted to the IMA over a 0.018 guidewire via puncture of the left axillary artery. Initially, the main body of the aortic stent-graft (Gore C3, size 23-14-16) was implanted to the infra renal segment of the aorta (below the renal arteries and the orifice using VIABAHN) via the right femoral artery. Next, the contralateral leg (Gore, 14-12-00) was implanted. Computed tomography was examined at 1- and 32-month postoperatively, and no endoleak or patency of IMA stent was detected. Conclusion: In this case of IMA-dependent circulation of the intestinal system, the protection of IMA via snorkel technique was successful.

scholarly journals Intrathrombus embolization of giant mesenteric inferior artery to prevent type II endoleak

2012 ◽  
Vol 65 (5-6) ◽  
pp. 255-258
Author(s):  
Momir Sarac ◽  
Ivan Marjanovic ◽  
Uros Zoranovic ◽  
Miodrag Jevtic ◽  
Sidor Misovic ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Type Ii ◽  
Type Ii Endoleak ◽  
Abdominal Aortic ◽  
The Right

Introduction. One of the most common complications of endovascular repair of abdominal aortic aneurysm is type II endoleak - retrograde branch flow. Case report. A 76-year-old man with abdominal aortic aneurysm, 7. 1cm in diameter and aneurysm of the right common iliac artery, 3. 2cm in diameter was admitted to our Department with abdominal pain. The patient had no chance of having open repair of abdominal aortic aneurysm because of high perioperative risk (cardiac ejection fraction of 23%, chronic pulmonary obstructive disease). Multislice computed angiography also revealed a large inferior mesenteric artery, 6mm in diameter with the origin in thrombus of aneurysm. We decided to repair abdominal aortic aneurysm with GORE? EXCLUDER ? stent-graft with crossed right hypogastric, but first we decided to embolize the inferior mesenteric artery. Angiography was performed through the right femoral approach and the good Riolan arcade was found. After that the inferior mesenteric artery was embolized with two coils, 5 mm in diameter, at the origin of artery in aneurysm thrombus. At the end of procedure, abdominal aortic aneurysm was repaired with GORE? stent-graft, and the control angiography was performed. There was no endoleak, and the Riolan arcade was very good. The patient was discharged after 5 days. There were no signs of ischemia of the left colon, and peristaltic was excellent. Control multislice computed angiography was done after 1 and 3 months. There were no signs of endoleak. On the control colonoscopy there were no signs of ischemia of the colon. Conclusion. Endovascular repair of symptomatic abdominal aortic aneurysm in high risk patients with preoperative embolization of large branch is the best choice to prevent rupture of abdominal aortic aneurysm and to prevent type II endoleak.

Atypical Endoleak Associated With Inadvertent Cannulation of the Ipsilateral Gate in an Ovation Trimodular Stent-Graft

2017 ◽  
Vol 52 (2) ◽  
pp. 135-137 ◽  
Author(s):  
Geert Maleux ◽  
Sabrina Houthoofd ◽  
Lien Poorteman ◽  
Inge Fourneau
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Endovascular Aortic Repair ◽  
Abdominal Aortic ◽  
The Right

We report on a 54-year-old man who presented with an atypical, proximal, intraoperative endoleak after endovascular aortic repair with an Ovation endograft for a 65-mm-diameter abdominal aortic aneurysm. The endografting was complicated by inadvertent bilateral iliac limb insertion into the right gate without cannulation of the left gate. The endoleak was treated by brachial approach: Through the open left gate, the outflow inferior mesenteric artery was coil embolized and the inflow left gate was closed with an Amplatzer plug. Follow-up computed tomography over 3 years showed absence of any endoleak and a stable diameter of the excluded abdominal aortic aneurysm.

Successful Embolization of Persistent Endoleak from a Patent Inferior Mesenteric Artery

1997 ◽  
Vol 4 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Greg van Schie ◽  
Kishore Sieunarine ◽  
Mike Holt ◽  
Michael Lawrence-Brown ◽  
David Hartley ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Abdominal Aortic ◽  
Contrast Enhanced ◽  
Retrograde Filling ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Purpose: To report the successful endovascular occlusion of a persistent endoleak owing to collateral perfusion in a 1-year-old bifurcated aortic endograft. Methods and Results: An 81-year-old man underwent endovascular repair of a 5.5-cm abdominal aortic aneurysm (AAA) with a bifurcated stent-graft in 1995; collateral perfusion of the excluded aneurysm by retrograde filling of the patent inferior mesenteric artery (IMA) was noted postoperatively. At his 1-year follow-up, the mid-sac endoleak persisted on contrast-enhanced computed tomography. Using the superior mesenteric artery for access, the stump of the IMA was successfully embolized with glue. Conclusions: This case, which highlights the importance of documenting a patent IMA prior to AAA endografting, illustrates one option for the management of persistent collateral perfusion of endovascularly excluded aneurysms.

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