iliac rupture during endovascular repair of the thoracic … · luis ricardo sanchez escalante...

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ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC AORTA LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO

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Page 1: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE

THORACIC AORTA

LUIS RICARDO SANCHEZ ESCALANTE

VASCULAR SURGEON

MONTERREY, MEXICO

Page 2: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

Disclosure

Speaker name:

LUIS RICARDO SANCHEZ ESCALANTE MD

I have the following potential conflicts of interest to report:

Consulting,

BAYER,

MEDTRONIC,

GORE,

BOSTON SCIENTIFIC

Page 3: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

Wath’s in the literature

During thoracic repair there may be a risk 8.9%

Increases the mortality and lenght of stay

It is more common in women

It is more common in thoracic repair vs EVAR

Use of internal endoconduit

Fernandez j et al. JVS dec 2009

Page 4: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

The height it does it matter?

Page 5: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU
Page 6: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

There is something that fits here?

Page 7: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

Minimum requirements

Page 8: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

Preparing the case

Page 9: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

But even when we do

Page 10: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

But wath happens?

Page 11: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

Iliofemoral bypass

Rediual

hematoma

Page 12: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

Things to think

1.-iliac diameter important

2.- if you pass the sheat easly

3.-remove the introducer slowly

4.- 2% cases TAA with rupture

5.- the last thing to leave is the guide

Page 13: ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE THORACIC … · LUIS RICARDO SANCHEZ ESCALANTE VASCULAR SURGEON MONTERREY, MEXICO. FiRISIVS MUG UERZÆ Hospital Alta Especialidad SU

ILIAC RUPTURE DURING ENDOVASCULAR REPAIR OF THE

THORACIC AORTA

LUIS RICARDO SANCHEZ ESCALANTE

VASCULAR SURGEON

MONTERREY, MEXICO