Raphael Coscas

Dr
  • Country: FR

Activities

Comment on Apr 06, 2020

Efstratios Georgakarakos commented on presentation How to perform a clampless hybrid aortic anastomosis.

»very impressive technique!!!! do you concern about the mid-and long term latency of the anastomotic stent? I mean, isn’t it risky to rely the efficacy of such anastomosis on the radial fords of a balloon-expandable stent (or is it stent-graft?) what are your results with this manuever?«
Technical note

How to perform a clampless hybrid aortic anastomosis

In various circumstances of aortic repairs, such as heavy circumferential calcifications or shaggy aorta with extensive thrombus, open and endovascular techniques are at high risk. In such cases, aortic clamping is fraught with risks of aortic rupture or emboli while endovascular techniques may not be successful with also a risk of emboli. Hybrid techniques may be an elegant solution. We describe here a hybrid technique that allows performing an aortic anastomosis without clamping thereby avoiding the above-cited risks. This educational video will allow other vascular surgeons to reproduce the technique.

Raphael Coscas
December 4, 2019 1 Comment
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Comment on Oct 05, 2018

Raphael Coscas replied to your comment on presentation Clampless Anastomosis on the Supraceliac Aorta for Aorto-mesenteric Bypass.

»Thank you for your comment, This is not our standard technique since it leave a stent across the anastomosis and some uncertainties remain about the durability. However, we performed our first case 3 years ago (on the infrarenal aorta) and the patient is still doing well with a patent stent and bypass.«
Comment on Oct 02, 2018

Theodosios Bisdas commented on presentation Clampless Anastomosis on the Supraceliac Aorta for Aorto-mesenteric Bypass.

»Great contribution Raphael. Did I understand your technique right? Are you puncturing the graft twice or only at the distal part? How are you puncturing the aortic wall in order to introduce your wire? My second question: can you provide us the diameters of the graft and the BeGraft? Do you perform any predilatation of the aorta at the level of the anastomosis?«
Poll 01/03/2019 – 31/03/2019

The chronic mesenteric ischemia

Patient’s characteristics

 

Gender: Female

Age: 69 years old

Comorbidity: Arterial hypertension, Dyslipidemia, coronary heart disease (DES deployment 2 years ago)

Symptoms:  Postprandial pain

Previous abdominal operations: None

DUS: Occlusion of the superior mesenteric artery

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