Volume 71 Number 1 January 2004	back to contents

¹Assistant Professor of Surgery and ²Assistant Professor, Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, NY.

Address all correspondence to Alfio Carroccio, M.D., Division of Vascular Surgery, Department of Surgery, Box 1273, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029.

ABSTRACT

In an attempt to improve the outcome following aortic aneurysm repair, there has been an increased focus on endovascular technology as a minimally invasive means of treating various vascular pathologies. Stent-grafting of aortic aneurysms is an area where a less invasive approach may decrease the morbidity seen with conventional aneurysm repair. As with other technologies, increased experience and improvements in instrument design allow for applicability to a broader population of patients. However, despite such improvements, some patients' anatomic characteristics may make endovascular repair unsuitable or too risky. When complex anatomy prohibits repair by endovascular means alone, a combination of conventional surgery and endovascular therapy may be utilized in an effort to minimalize the invasiveness. Using adjunctive surgical procedures, complex anatomy may be modified to allow for a safe and successful endovascular aneurysm repair. In this paper, we describe the modification of access vessels as well as fixation sites to facilitate the endovascular treatment of aortic aneurysms.

KEYWORDS

Endograft, aneurysm, open surgical reconstruction, endovascular techniques, thoracic aorta, iliac arteries.

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