SMA vein interposition bypass with reimplantation of jejunal arteries
Dissecting aneurysm of the SMA with previous ligation of hepatic artery due to a ruptured aneurysm 3 years before
Suprarenal fixation of aortic stentgraft can be left in place when explantation is performed in uninfected situations such as ruptured endoleak or acute thrombosis. In case of infections and especially in stentgraft-enteric fistula, this strategy can promote reinfection and recurrence of the fistula. Total control of the suprarenal aorta and visceral arteries revascularisation can be achieved through a left retroperitoneal approach but with poor access to repair the bowel in case of fistula. In this situation midline laparotomy is the best approach to perform the repair of the bowel and syringe extraction represents a valuable option to explant the stentgraft
Step by step procedure on how to explant an aortic and iliac branch endoprosthesis with minimal duration of suprarenal aortic cross clamping in a patient with altered renal function.