Why the study?
Does the 'crossing the limbs' technique improve successful deployment of the AneuRx stent-graft in AAAs with acutely angled aortic necks?
Does the 'crossing the limbs' technique improve successful deployment of the AneuRx stent-graft in AAAs with acutely angled aortic necks?
Crossing the graft limbs during AneuRx stent-graft deployment is a useful technique for managing severely angulated aortic necks in endovascular AAA repair.
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Supports technical feasibility of limb crossing in 7 angulated-neck cases; leaves open need for prospective validation before practice change.
PURPOSE: To describe a technique for deploying an AneuRx stent-graft in an abdominal aortic aneurysm (AAA) with an acutely angled aortic neck. TECHNIQUE: In routine cases, the AneuRx stent-graft main body is positioned with the nose cone notch facing the contralateral side. In severely angulated aortic necks, however, the main body of the AneuRx stent-graft can be positioned with the nose cone notch and iliac limb gate facing the ipsilateral side; this dramatically reduces the acuity of the angle at the aortic neck and the iliac gate. This technique of "crossing the limbs" has been successfully used in 7 cases since FDA approval of the AneuRx device. CONCLUSIONS: Proximal neck angulation is an important factor for successful endovascular AAA repair. Crossing the graft limbs reduces the effect of neck angulation on the proximal main body and may decrease the stress upon the contralateral limb gate, which may avoid graft gate disconnection and endoleak.
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Ramaiah et al. (2002) studied this question.
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