endoproth é se branch è e hypogastrique Alexandros Mallios 2010 2011 COLLEGE CHIRURGIE VASCULAIRE IDF C est quoi une endoproth èse branché hypogastrique Pourquoi Faire ID: 224896
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Slide1
“Mise en place d' une
endoproth
é
se branch
è
e hypogastrique”
Alexandros Mallios
2010 – 2011 COLLEGE CHIRURGIE VASCULAIRE IDFSlide2
C' est quoi une
“endoproth
èse branché hypogastrique”
???Slide3Slide4
Pourquoi Faire
???
(Indications)
Préservation de l'artère iliaque interne et de la perfusion pelvienneSlide5
20 – 30 %
des malades avec un AAA
ont aussi aneurysmes
des art
è
res iliaquesSlide6
endoprothèses - importance des zones d'étanchéitéSlide7
Branches / Coils
Claudication de la fesse 45%
Ischémie du périnée, du côlon ou de la moelle
L'impuissance sexuelleSlide8
Les tentatives précédentesSlide9Slide10Slide11
Endoproth
é
ses Branch
è
es - depuis 2002
Side branch Helical BranchSlide12
“Par l' int
é
rieur”Slide13
“ Preloaded Catheter”Slide14
Comment Faire
???Slide15
10 mm
“Le lasso”Slide16
10 mm
10 mm
“through and through wire
&
introducteur en cross over”Slide17Slide18
Deuxi
ème wire en parallèle
&
et passage du “bridging stent graft”Slide19
“largage du stent graft”Slide20
Mise en place de l' endoproth
è
seSlide21
“Mise en place du bridging stent graft”Slide22
VIDEOSlide23
L'évolution récente
“Bifurcated – bifurcated graft”
Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OHSlide24
L'évolution récente
“Bifurcated – bifurcated graft”
Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OHSlide25
L'évolution récente
“Bifurcated – bifurcated graft”
Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OHSlide26
L'évolution récente
“Bifurcated – bifurcated graft”
Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OHSlide27
Résultats dans la littératureSlide28
Résultats dans la littératureSlide29
Contraindications absolues:
1. Aneurysme de l' artere Hypogastrique
2. Stenose de l' artere Hypogastrique
3. Diam
è
tre r
é
siduelle de l artere iliaque primitive
< 1,8 cm (lumiere sans thrombus)Slide30
Conclusions
No doubt in the importance of IIA maintenance
Placement of a branched endograft for the IIA seems to be feasible and with good results
Technology and experience is improving and this normally will be reflected in the results
More evidence required for evaluationSlide31
Literature – Articles a
é
tudier
1. Tielliu et al. The role of branched endografts in preserving internal iliac arteries. J Cardiovasc Surg 2009;50:213-8
2. Malina et al. Feasibility of a Branched Stent Graft in Common Iliac Artery Aneurysms. J Endovasc Ther 2006;13:496-500
3.Greenberg et al. Beyond the aortic bifurcation: Branched endovascular grafts for thoracoabdominal and aortoiliac aneurysms J Vasc Surg 2006;43:879-86
4.Verzini et al. Endovascular treatment of iliac aneurysm: concurrent comparison of side branch endograft versus hypogastric exclusion J Vasc Surg 2009;49:1154-61
5.Dias et al. EVAR of Aortoiliac Aneurysms with Branched Stent grafts.EurJ Vasc Endovasc Surg 2008;35:677-84
6.Bergamini et al. External iliac artery to internal iliac artery endograft: A novel approach to preserve pelvic inflow in aortoiliac stant grafting J Vasc Surg 2002;35:120-47.Kritpracha et al. Bell bottom aortoiliac endografts: An alternative that preserves pelvic flow. J Vasc Surg 2002;35:874-81Slide32
Merci pour votre attention :-)