PubMed · 7637477
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J Collin. 1995-08-19. Transluminal aortic aneurysm replacement.. https://doi.org/10.1016/s0140-6736(95)91318-1
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Stenting or transluminal implantation of vascular endoprostheses is a new modality among many endovascular techniques. Experience is greatest in the iliac arteries where patency rates above 90% are reported. Because in femoropopliteal arteries the patency rates are below 70%, stents should be implanted only in situations where percutaneous transluminal angioplasty (PTA) alone has failed. Similar results are obtained with implantation in renal and supraaortic arteries. Application in great veins for palliation of tumor compression seems to be a good indication. A new perspective opens up with "covered stents" to treat aorto-iliac aneurysms endoluminally. Even though stenting is still experimental in some regards, and open surgical reconstruction represents the established standard, it has great therapeutic potential. However, endovascular techniques should neither be rejected nor simply adopted by vascular surgeons but developed further in a team approach with experienced interventional angiologists and radiologists.
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The insertion of the inflation needle during laparoscopic procedures carries the risk of severe vascular damage to the aorto-cava bifurcation. Interindividual anatomic variation is great as shown by magnetic resonance imaging, increasing the risk of vascular damage. Four simple technical precautions are recommended to prevent accidents: insertion at the lower umbilical margin, widen distance between the umbilicus and the greater vessels, a 45 degree insertion angle and strictly medial position.