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This is a dictation for abdominal aortic aneurysm repair with open cutdown
of the left common femoral artery.

PROCEDURES PERFORMED:
Angioplasty of right common iliac, angioplasty of left common iliac,
right common iliac stent, left common iliac artery stent and common
femoral artery patch angioplasty.

INDICATION FOR PROCEDURE:
Abdominal aortic aneurysm with bilateral iliac disease.

PROCEDURE PERFORMED:
The patient was prepped and draped in the usual sterile fashion. After
the appropriate time-out, the left common femoral artery was cut down
and a 6-French sheath was placed in the right common femoral artery.
The patient was anticoagulated to a therapeutic ACT. Following that,
a bifurcated AFX graft was advanced. The main body was 28 x 110. The
aim was to try and preserve the patient’s right hypogastric as the left
hypogastric was already coiled. The graft was delivered. The contralateral
limb was snared per standard fashion. The graft was pulled down to the
bifurcation and the graft was deployed. We did lose the left sheath
as the delivery device hung up on the graft, but we were able to keep
access, and a 14-French sheath was placed in the left common femoral
artery. We then deployed the cuff and secured the graft up to the renals.
Again, the delivery system was stuck on stent graft and needed to be
removed after some rotation. A 10 x 17 balloon expandable stent was
then placed on the right after angioplastying the graft at the iliacs.
On the left, a 10 x 59 VBX stent was deployed. Completion angiogram
showed excellent iliac arteries with good graft apposition. There was
no significant endoleak. The hypogastric artery was preserved. There
were no complications. The left
common femoral artery was patched and an Angio-Seal closure device was
placed on the right. There were no complications. Further recommendations
to follow hospital course.