Abdominal Aortic Aneurysm - Endovascular Therapy

Longitudinal skin incision bilaterally in the inguinal fold and medial displacement of the lymphatic vessels, opening of the thigh fascia, looping of the femoral artery using a tourniquet.

Puncture of the common femoral artery using a hollow needle, insertion of a guidewire, exchange of the needle for the sheath (1 x left, 2 x right)

Advancing a hydrophilic (Terumo) wire via the left pelvic arterial pathway into the thoracic aorta, over which a (Multipurpose) catheter is then introduced; Exchange of the hydrophilic wire for a stiff wire (Back-up Meier).

Probing of the pelvic vascular pathway using a hydrophilic (Terumo) wire, over which an angiography catheter (Pigtail) is advanced into the suprarenal aorta (approx. level L1); Removal of the wire.

Removal from the packaging, rinsing with heparin saline solution, extracorporeal fluoroscopy.

Removal of the sheath while leaving the stiff guidewire in place, advancing the main prosthesis body over the stiff guidewire under X-ray fluoroscopy into the aorta while maintaining the correct rotational position.

Alignment of the image intensifier, connection of the angiography pump via a pressure hose to the angiography catheter, instillation of contrast medium during breath hold, depiction of the origins of the renal arteries, which are marked on the screen.

Primary partial release of the proximal stent of the prosthesis main body directly distal to the renal artery ostia by withdrawing the delivery sheath under X-ray fluoroscopy, orientation using the radiopaque markers, then repeated X-ray check and subsequently further release until complete deployment of the contralateral iliac prosthesis limb.

Probing of the right iliac portion of the main prosthetic body using a hydrophilic (Terumo) wire through the 2nd sheath with the aid of a catheter, verification of the correct intraluminal position by free rotation of a pigtail catheter, insertion of a stiff guidewire (Back-up Meier).