Many surgeons prefer the retroperitoneal approach to repair of aortic aneurysms only in ‘high-risk’ patients but the authors apply this approach to all patients in an effort to minimize operative trauma and shorten hospital stay. The approach used at this centre is usually the ‘extended’ retroperitoneal approach first reported by Williams et al.1 because this posterolateral exposure of the aorta affords the widest and most flexible exposure. Use of a more anterior retroperitoneal exposure (as originally reported by Rob2 and more recently advocated by others) limits aortic exposure and in many instances is more technically difficult to perform. However, it is very similar anatomically to that gained by transperitoneal techniques and many surgeons feel more comfortable with the anterior approach, rather than the relatively unfamiliar posterolateral approach.
KeywordsCatheter Ischemia Heparin Polypropylene Mannitol
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