Key result
Aortic balloon occlusion via direct graft puncture achieves supracoeliac control in <5 minutes during endograft explantation.
Case Report (n=2)
Direct graft puncture with an aortic balloon offers a fast and safe method for proximal aortic control during complex abdominal endograft explantations, avoiding technically demanding dissections.
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May simplify suprarenal control during endograft explantation; leaves open need for larger series to confirm safety.
The late removal of an abdominal aortic endograft is technically challenging and can be associated with significant blood loss, especially when a graft with active suprarenal fixation is involved. The main issue in safe explantation of the endograft is control of the aorta above the proximal fixation site. We report an adjunctive technique for the safe and fast proximal control of the suprarenal aorta using an aortic balloon. The endograft is directly punctured and an aortic balloon is deployed and inflated above the fixation site in the supracoeliac aorta. The time for supracoeliac control in our 2 patients was <5 min. This simple technique offers a safe and fast aortic control during the removal of the endograft, especially when active suprarenal fixation is used, avoiding the risks from a technically demanding dissection in a potentially inflammatory region.
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Matsagkas et al. (2014) conducted a case report in Explantation of an abdominal endograft with suprarenal fixation (n=2). Proximal aortic control using an aortic balloon through direct graft puncture was evaluated on Time for supracoeliac control. Proximal aortic control using an aortic balloon through direct graft puncture achieved supracoeliac control in <5 minutes during abdominal endograft explantation in 2 patients.
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