Safety maneuvers to prevent embolism complicating endovascular aortic repair.

The endoluminal approach of the diffusely atheromatous aorta (DAA) is an emerging tool to prevent further embolization. We treated one symptomatic patient with DAA. We designed a catheter with a balloon at the tip for occlusion of both common iliac arteries through which the antegrade flow was allowed by an iliac to femoral arterio-arterial shunt connected to an in-line filter. Filter wires were also placed in the superior mesenteric and both renal arteries' take-off, keeping their antegrade flow. The endograft was then introduced through these tubes. Endoluminal treatment of the primary source of atheromatous embolization is feasible, representing a new approach to be considered.