How do you deal with these arteries during repair of an abdominal aortic aneurysm?
- Lumbar artery orifices are normally oversewn to prevent back bleeding from collaterals.
- At repair there are several orifices you may see.
- Posteriorly are the lumbar arteries, laterally the renal arteries, which must be preserved, and anteriorly the superior and inferior mesenteric arteries.
- In suprarenal AAA repair the superior mesenteric artery is normally reimplanted.
- The inferior mesenteric artery is occluded, unless it is patent and not vigorously back bleeding, in which case it is also reimplanted.