The combined endovascular and open surgical approach is feasible, without cross clamping of the aorta and with minimized ischemia time for renal and visceral arteries, and seems to be an appropriate strategy for patients with a thoraco-abdominal aortic aneurysm or dissection.
Our report suggests that a BOT of the CA is a feasible and safe procedure. It can demonstrate collateral pathways before definite coverage is performed. This test might be useful for selection of patients prior intended coverage of the CA.
Changes in systemic blood pressure during CEA under local anaesthesia seem to influence shunting rather marginally. The value of induced hypertension to prevent cerebral ischemia should be newly discussed.
The modification of the PAI technique with a basilic vein as presented here showed similar results to the original PAI procedure. This new procedure does not require prosthetic grafts as in the original PAI technique or a central venous catheter and leads to the enlargement of the puncture site as a result of the superficialization of the basilic vein. Therefore, it is believed that this new technique could be a good option for those patients with matured cephalic and basilic veins who suffer from severe access-related ischemia.
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