Staged thoracic and abdominal aortic aneurysm repair using stent graft technology and surgery in a patient with acute renal failure

Simultaneous Endovascular Exclusion of Thoracic Aortic Aneurysm with Open Abdominal Aortic Aneurysm Repair

BACKGROUND

The treatment of aneurysms at multiple sites within the aorta is problematic.

METHODS

Between March 2002 and June 2003 in the Department of General, Vascular and Transplant Surgery, Medical University of Warsaw six patients with coexisting abdominal and descending thoracic aortic aneurysms underwent simultaneous open abdominal aortic aneurysm (AAA) repair and endoluminal thoracic aortic aneurysm (TAA) repair. The indication for a combined procedure was a diagnosed descending TAA and AAA with no significant risk factors for open aortic surgery or technical contraindications for endovascular treatment of TAA.

RESULTS

One patient died in the peri-operative period while the other five patients all recovered well after surgery and were discharged with both aneurysms excluded.

CONCLUSION

Endovascular treatment of TAA combined with a simultaneous open AAA repair is an efficient and relatively safe treatment modality in patients with TAA and AAA disqualified from endovascular repair. The fact that thoracotomy is not a necessity significantly lowers the complication rate in these patients.

Simultaneous stent-graft repair of thoracic and infrarenal abdominal aortic aneurysms

PURPOSE

To describe a technique for concomitant endovascular stent-graft repair of thoracic and infrarenal abdominal aortic aneurysms.

CASE REPORT

A 68-year-old man was found to have concomitant thoracic and abdominal aortic aneurysms. Both of the aneurysms were excluded successfully in one procedure using Talent stent-grafts. The patient tolerated the procedure well and was discharged on postoperative day 4. Aside from an infected groin wound, the patient did not have any complications. Computed tomographic scans at 6, 12, and 18 months showed proper position of both stents without evidence of endoleak.

CONCLUSIONS

Simultaneous endovascular treatment of thoracic and infrarenal abdominal aortic aneurysms may represent a viable alternative for therapy in some patients.