19
Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD. Vascular Surgery Unit, Benha University, Egypt. 1/30/2020 1

Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

  • Upload
    others

  • View
    8

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation

By

Ahmed Khairy Allam, MD.

Vascular Surgery Unit, Benha University, Egypt.

1/30/2020 1

Page 2: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Disclosure

Speaker name: Ahmed Khairy Allam

Departments of General Surgery, Vascular Surgery Unit, Benha University

I have the following potential conflicts of interest to report:

Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

Other(s)

I do not have any potential conflict of interest

Page 3: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Background

▪ Male patient 63 years old known to be type II insulin dependent diabetes mellitus

▪ Chronic heavy smoker (SI= 880)

▪ IHD with history of CABG (2 vessel) since 2013 followed by coronary stenting 3 years later

▪ EF=44%

▪ Underwent bilateral CIA stenting since 2018

Page 4: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Clinical presentation

1/30/2020 4

Page 5: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Investigation

Page 6: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Decision

Page 7: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD
Page 8: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 8

Page 9: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 9

Page 10: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 10

Page 11: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 11

Page 12: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 12

Page 13: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 13

Page 14: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 14

Page 15: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 15

Page 16: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

1/30/2020 16

Page 17: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Discussion & Conclusion

▪ in situ fenestration (ISF) of standard endografts

represents another off-label endovascular means

to maintain perfusion to aortic side branches

located in the excluded area

Page 18: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

▪ First described in 2004 by McWilliams et al., Its principle is based on intentionally made fenestration of an endograft following its deployment inside the vascular system

▪ It is currently an off-label procedure that should not be used outside emergent bailout techniques

Page 19: Retrograde Fenestration of Inadvertently Deployed Stent Graft … · Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation By Ahmed Khairy Allam, MD

Retrograde Fenestration of Inadvertently Deployed Stent Graft over Aortic Bifurcation

By

Ahmed Khairy Allam, MD.

Vascular Surgery Unit, Benha University, Egypt.

1/30/2020 19