A biggie #AortaEd How would you fix?

Transabdominal, juxtarenal, can sew at the level of renals. Supra-renal clamp, looks like you can clamp if downward traction on sac, if not supraceliac clamp, decompress sac, move clamp down. Aorto-bi-iliac graft. Would like to see coronal. My record 18 cm dia. #AortaEd

18 cm!

Yup, it was a Thanksgiving weekend several years ago. I took an intraop picture cause I thought no one would believe me.

Share when (if) possible!

I’ll have to dig it out of the archives. We were able to do it just as I described. Downward traction on the sac, suprarenal clamp, so at the level of the renals. Please give us follow-up.

The open repair is a very good and the most durable option here.

10 blade, Dacron, 3-0 Prolene on MH-1

And they are very thin!!!!!!! In other words they don’t live in Oklahoma

Oops, cold steel and bright lights

Open. Likely retro if no contraindications

Autoclave steel and Dacron

Cancer? I'm not an expert but doesn't look like any endo options ...

Can’t steel and bright lights

Open retro with William Sicard approach, 11th rib out. Above Sma or CT clamping. Oblique Proximal anastomosis with LRA reimplantig. Renal protection with Custudiol.

OR !