Extraperitoneal laparoscopic aortic control with endovascular visualization of a stent-graft combination

Objectives: to demonstrate the feasibility of minimally invasive approaches to the aorta using retroperitoneal laparoscopy and to clamp the aorta to g ive Views for perfemoral aortic angioscopy, Methods: using retroperitoneal laparoscopy facilitated by balloon dissection the authors developed a new a pproach to the infrarenal abdominal aorta, in six pigs, to allow control of aortic blood flow. Aortic stent-grafts were then deployed via femoral arte riotomy, and after flushing the blood from the aorta. the stent-grafts were visualized by angioscopy, Results: accurate positioning and patency of the stent-grafts was ascertained by direct Vision angioscopy in all cases. Con clusions: this series shows that extraperitoneal laparoscopic aortic dissec tion is feasible and direct endovascular visualization of the aortic lumen can be performed, This may find a role as an adjunct to endovascular techni ques such as endovascular stent-graft placement, by aortic angioscopy follo wing minimally-invasive aortic clamping. (C) 1999 The International Society for Cardiovascular Science. Published by Elsevier Science Ltd. All rights reserved.