Transbrachial branch cannulation during Zenith fenestrated endovascular aortic aneurysm repair using a robotically guided body-floss technique

Caudal angulation and stenosis of the renal arteries pose significant challenges in branch cannulation during the standard fenestrated endovascular aortic aneurysm repair (FEVAR). We describe an alternative technique of branch cannulation during FEVAR in a patient with a 6.5-cm juxtarenal abdominal...

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Bibliographic Details
Main Authors: Sukgu M. Han, MD, Anuj Mahajan, MD, Sung W. Ham, MD, William Lee, MD, Vincent L. Rowe, MD, Fred A. Weaver, MD
Format: Article
Language:English
Published: Elsevier 2016-09-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2352667X16300029
Description
Summary:Caudal angulation and stenosis of the renal arteries pose significant challenges in branch cannulation during the standard fenestrated endovascular aortic aneurysm repair (FEVAR). We describe an alternative technique of branch cannulation during FEVAR in a patient with a 6.5-cm juxtarenal abdominal aortic aneurysm, renal artery stenosis, and bilateral caudally oriented renal arteries. A brachiofemoral or “body-floss” access was established by traversing the top scallop. The brachial sheath was deflected toward the target fenestration using a steerable robotic femoral sheath, enabling transbrachial cannulation of the downgoing target renal artery. Postoperatively, the patient was discharged without complications. Steerable sheath-guided body-floss technique may facilitate cannulation of severely downgoing branch vessels during FEVAR.
ISSN:2468-4287