A Laparoscopic Approach to the Abdominal Aorta for Thoracic Stent-Graft Deployment: Evaluation in a Porcine Model

Abstract

Thoracic aortic stent-grafting using a laparoscopic approach to the infrarenal aorta is feasible. More studies will be required to define the place of combined endovascular and laparoscopic procedures as an alternative to the femoral surgical approach for stent-graft placement.

Direct Videoscopic Approach to the Thoracic Aorta for Aortic Endograft Delivery: Evaluation in a Human Cadaver Circulation Model

“…Laparoscopic techniques have been developed to provide a minimally invasive solution. Formichi et al 9 described a laparoscopic approach to the abdominal aorta for thoracic endograft deployment in a porcine model. Although deployment of the stent-grafts was successful, the procedure required dissection of the entire infrarenal aorta.…”

A Laparoscopic Endovascular Aortobifemoral Conduit That Can Be Retained as a Long-term Bypass: A Solution for Patients With Inadequate Iliac Access

“…In the current procedure, blood loss could be expected on withdrawal of the needle over the wire or during wire exchange by catheter; either could be minimized by use of a balloon or clamps. Formichi et al 20 described a retroperitoneal laparoscopic technique for implanting stent-grafts into the thoracic aorta of the pig. Median blood loss was 110 mL, but little bleeding occurred on aortic puncture or insertion of guidewires.…”

Direct Videoscopic Approach to the Descending Thoracic Aorta for Aortic Arch Endograft Delivery: Evaluation in a Porcine Model

“…[9][10][11][12] The latest developments combine these endoscopic experiences with current endovascular techniques 13 into so-called hybrid procedures with direct vascular access to the aorta for the insertion of an endograft. Formichi et al 14 described a successful laparoscopic approach to the abdominal aorta for thoracic endograft deployment in a porcine model, but as in other laparoscopic vascular procedures, exposure of the aorta presents technical difficulties. The aorta is exposed either via a transperitoneal or a retroperitoneal approach or a combination of both.…”