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“Mise en place d' une endoproth é se branch è e hypogastrique” Alexandros Mallios

“Mise en place d' une 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 ??? (Indications)

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“Mise en place d' une endoproth é se branch è e hypogastrique” Alexandros Mallios

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  1. “Mise en place d' une endoprothése branchèe hypogastrique” Alexandros Mallios 2010 – 2011 COLLEGE CHIRURGIE VASCULAIRE IDF

  2. C' est quoi une “endoprothèse branché hypogastrique” ???

  3. Pourquoi Faire ??? (Indications) Préservation de l'artère iliaque interne et de la perfusion pelvienne

  4. 20 – 30 % des malades avec un AAA ont aussi aneurysmes des artères iliaques

  5. endoprothèses - importance des zones d'étanchéité

  6. Branches / Coils Claudication de la fesse 45% Ischémie du périnée, du côlon ou de la moelle L'impuissance sexuelle

  7. Les tentatives précédentes

  8. Endoprothéses Branchèes - depuis 2002 Side branch Helical Branch

  9. “Par l' intérieur”

  10. “ Preloaded Catheter”

  11. Comment Faire ???

  12. 10 mm “Le lasso”

  13. 10 mm 10 mm “through and through wire & introducteur en cross over”

  14. Deuxième wire en parallèle&et passage du “bridging stent graft”

  15. “largage du stent graft”

  16. Mise en place de l' endoprothèse

  17. “Mise en place du bridging stent graft”

  18. VIDEO

  19. L'évolution récente “Bifurcated – bifurcated graft” Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OH

  20. L'évolution récente “Bifurcated – bifurcated graft” Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OH

  21. L'évolution récente “Bifurcated – bifurcated graft” Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OH

  22. L'évolution récente “Bifurcated – bifurcated graft” Courtesy of Dr Roy Greenberg – Cleveland Clinic, Cleveland OH

  23. Résultats dans la littérature

  24. Résultats dans la littérature

  25. Contraindications absolues: 1. Aneurysme de l' artere Hypogastrique 2. Stenose de l' artere Hypogastrique 3. Diamètre résiduelle de l artere iliaque primitive < 1,8 cm (lumiere sans thrombus)

  26. 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 evaluation Conclusions

  27. 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;35:120-4 7.Kritpracha et al. Bell bottom aortoiliac endografts: An alternative that preserves pelvic flow. J Vasc Surg 2002;35:874-81 Literature – Articles a étudier

  28. Merci pour votre attention :-)

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