Guidelines for clinical practice
Copyright ©2009 Baishideng Publishing Group Co.
World J Radiol. Dec 31, 2009; 1(1): 50-62
Published online Dec 31, 2009. doi: 10.4329/wjr.v1.i1.50
Table 1 Anatomic considerations
Anatomical features to considerImplications
Diameter of proximal and distal landing zonesDetermines size of endograft that can/should be utilized
Distance from lesion to origin of left subclavian arteryWill obtaining an adequate landing zone require coverage of the left subclavian artery?
Distance from lesion to origin of left common carotid arteryIf required, is there room to land distal to the origin of the left common carotid artery? Will there be room, if needed, to clamp distal to the origin or will circulatory arrest be needed if subsequent operative repair is needed?
Degree of curvature across the proximal landing zoneIs there a high likelihood that to avoid malposition along the inner curvature that the graft will have to placed more proximally?
Quality of the aortaIs there significant thrombus and/or calcification that would pose a risk of stroke or Type I endoleak?
Quality of access vesselsIs the diameter sufficient to permit the required sheath? Are there more proximal calcifications and/or tortuosity that might prevent safe passage of the sheath?
Distance from proposed access vessel to the lesionDoes the system being used have sufficient length to reach the proposed site?
Length of the injuryIf using cuffs, how many may be required to ensure fixation
Vascular anomaliesAnomalous origin of left vertebral artery? Patent LIMA graft? Aberrant origin of right subclavian artery?