Boston Scientific Corporation · NYSE:BSX
Boston Scientific — Technical Presentation
10 slides from Boston Scientific's technical presentation
Slide 1: Hypogastric Artery Bypass to Preserve Pelvic Circulation in Association with Endovascular Aneurysm Repair
Hypogastric Artery Bypass to Preserve Pelvic Circulation in Association with Endovascular Aneurysm Repair Frank R. Arko, MD Chief, Endovascular Surgery Assistant Professor of Surgery University of Texas Southwestern Medical Center Dallas, TX http://www.bostonscientific.com/vsfellowspartnership http:
Slide 2: Introduction
Introduction EVAR offers a less invasive alternative to open surgical repair of AAA Patients with aortoiliac aneurysms can be treated with EVAR – “Bell-bottom technique” – Often coil embolization of hypogastric artery is required Can result in hip and buttock claudication http://www.bostonscientific
Slide 3: Introduction: Hip and Buttock Claudication
Introduction Hip and Buttock Claudication Incidence 26-41% Symptoms may persist Some authors recommend hypogastric artery bypass to preserve pelvic circulation *Razavi et al, Lee et al, Cynamon et al, Lee et al http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscientific.com/vsfe
Slide 4: Treatment Options
Treatment Options Hypogastric artery bypass can be performed rather than coil embolization in the management of common iliac artery aneurysms in the endovascular repair of aortoiliac aneurysms to perserve flow to the pelvis http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscient
Slide 5: Coil Embolization
Coil Embolization Patency of contralateral artery Internal Iliac Artery assessed prior to Embolized and Coiled embolization http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscientific.com/vsfellowspartnership 5
Slide 6: Patients
Patients Coil Embolization Hypogastric Artery Hypogastric Artery Bypass Coils Hemashield® Gold™ Microvel® Knitted Double Velour Vascular Graft Bypass (8mm) http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscientific.com/vsfellowspartnership 6
Slide 7: Hypogastric Artery Bypass
Hypogastric Artery Bypass Small retroperitoneal incision Proximal hypogastric oversewn 8 mm Hemashield® Gold™ Microvel® Knitted Double Velour Vascular Hypogastric Artery Graft end-to-end to hypogastric 8 mm conduit to external iliac artery for device External Iliac Artery Bypass Graft deployment htt
Slide 8: Results
Results Coil Embolization – 50% with claudication Hypogastric Hemashield® Gold™ Microvel® Knitted Bypass Double Velour – No Vascular Graft to Hypogastric Artery claudication Arko et al, JVS http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscientific.com/vsfellowspartnership 8
Slide 9: Conclusions
Conclusions Hypogastric artery bypass to preserve pelvic circulation is safe and significantly decreases the risk of buttock claudication http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscientific.com/vsfellowspartnership 9
Slide 10: Conclusions
Conclusions Preservation of pelvic circulation results in a three-fold improvement in the ambulatory status of patients with common iliac artery aneurysms compared to coil embolization http://www.bostonscientific.com/vsfellowspartnership http://www.bostonscientific.com/vsfellowspartnership 10