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December 23, 2005
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Deepak Nair, MD, Li Sheng Kong, MD, C. Daniel Smith, MD, Karthikeshwar Kasirajan, MD.
Emory University Hospital, Decatur, GA, USA.
OBJECTIVES: Laparoscopic aortic procedures are gaining popularity for both aneurismal and occlusive disease of the abdominal aorta. They combine the early post-operative recovery associated with endovascular procedures with the long-term durability of open surgical techniques. However, one of the main contraindications to laparoscopic aorto-bifemoral (L-ABF) procedures is circumferential aortic calcification at the level of the proximal neck.
METHODS: We describe a case of a 55 year old woman with aortic occlusive disease and life-style limiting claudication. She was at a high risk for open bypass due to uncorrectable coronary artery disease. Patient was also noted to have dense circumferential aortic calcification on her CT images.
RESULTS: A laparoscopic aortic endarterectomy was performed to facilitate the proximal anastomosis. The patient was discharged from the hospital on the fourth post-operative day with palpable pedal pulses. Following discharge her claudication symptoms completely resolved.
CONCLUSIONS: This case report demonstrates the first description of a laparoscopic aortic endarterectomy procedure to expand the indications for L-ABF.
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Laparoscopic Aortic Endarterectomy to Facilitate Laparoscopic Aorto-Bifemoral Bypass
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Deepak Nair, MD, Li Sheng Kong, MD, C. Daniel Smith, MD, Karthikeshwar Kasirajan, MD.
Emory University Hospital, Decatur, GA, USA.
OBJECTIVES: Laparoscopic aortic procedures are gaining popularity for both aneurismal and occlusive disease of the abdominal aorta. They combine the early post-operative recovery associated with endovascular procedures with the long-term durability of open surgical techniques. However, one of the main contraindications to laparoscopic aorto-bifemoral (L-ABF) procedures is circumferential aortic calcification at the level of the proximal neck.
METHODS: We describe a case of a 55 year old woman with aortic occlusive disease and life-style limiting claudication. She was at a high risk for open bypass due to uncorrectable coronary artery disease. Patient was also noted to have dense circumferential aortic calcification on her CT images.
RESULTS: A laparoscopic aortic endarterectomy was performed to facilitate the proximal anastomosis. The patient was discharged from the hospital on the fourth post-operative day with palpable pedal pulses. Following discharge her claudication symptoms completely resolved.
CONCLUSIONS: This case report demonstrates the first description of a laparoscopic aortic endarterectomy procedure to expand the indications for L-ABF.
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