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Tello-Díaz C, Romero Carro JM, Soto Carricas B, Moreno J, Aloy Ortiz C, Dilmé JF. Type Ib endoleak repaired with a thoracic endovascular graft inside previous visceral debranching bypass in a patient with chronic type B aortic dissection. J Vasc Surg Cases Innov Tech 2023; 9:101186. [PMID: 37305360 PMCID: PMC10250905 DOI: 10.1016/j.jvscit.2023.101186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/28/2023] [Indexed: 06/13/2023] Open
Abstract
We present the case of a patient with chronic type B aortic dissection with a previous iliac to visceral debranching graft and thoracoabdominal endograft who, because of a type Ib endoleak and aortic diameter enlargement, required a complex solution involving placement of a thoracic endovascular graft inside a Dacron graft with a 180° curved shape in three-stage surgery. At 9 months of follow-up, he had no evidence of type I endoleaks, and the aortic diameter had decreased.
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Affiliation(s)
- Cristina Tello-Díaz
- Correspondence: Cristina Tello-Díaz, MD, Department of Vascular Surgery, Hospital of the Holy Cross and Saint Paul, Passeig Vall d’Hebron 119-129, Barcelona 08035, Spain
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Staged Hybrid Repair of a Complex Type B Aortic Dissection. J Cardiovasc Dev Dis 2022; 9:jcdd9090297. [PMID: 36135442 PMCID: PMC9503553 DOI: 10.3390/jcdd9090297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Due to its heterogeneous clinical picture and lengthy evolution, the management of type B aortic dissection represents a clinical challenge, often calling for complex strategies combining medical, endovascular, and open surgical strategies. We present the case of a 45-year-old female who had previously suffered a complicated type B aortic dissection requiring a femoro-femoral crossover bypass and further conservative treatment. Seven years later, due to an aneurysmal development, a staged descending aortic management was strategized, beginning with the implantation of a frozen elephant trunk device due to an insufficient proximal landing zone for endovascular repair. However, the development of a distal stent graft-induced new entry complicated the dissection and led to the formation of a second false lumen, thus prompting an expedited hybrid reconstruction. We describe a hybrid repair strategy tailored to the patient’s particular aortic anatomic conformation, combining ilio-visceral debranching and thoracic endovascular aortic repair. Due to a lack of consensus on the ideal management strategy for type B aortic dissection, an individualized approach conducted by an experienced aortic team may generate the best outcome. The appropriate timing and planning of the intervention are the keys to successful results in complex type B aortic dissection cases with an elaborate anatomic conformation.
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Effect of Anastomosis Angles on Retrograde Perfusion and Hemodynamics of Hybrid Treatment for Thoracoabdominal Aortic Aneurysm. Ann Vasc Surg 2021; 79:298-309. [PMID: 34648850 DOI: 10.1016/j.avsg.2021.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/09/2021] [Accepted: 08/14/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hemodynamic effects on the retrograde visceral reconstruction (RVR) for thoracoabdominal aortic aneurysms treatment by anastomotic angle remains unclear. This study aims to qualitatively and quantitatively investigate the effects of different anastomotic angles on hemodynamics and patency. METHODS Three RVR models with 45°, 60° and 90° anastomotic angles were reconstructed respectively by manipulating apostoperative patient-specific model. The manipulated models of the RVRs were numerically simulated and analyzed in terms of hemodynamics including theinstant and cumulative patency, flow pattern and indicators based on wall shear stress (WSS). RESULTS Although a smaller anastomotic angle may decrease the patency rate of common iliac arteries, it can improve the visceral perfusion during a cardiac cycle. More importantly, RVR with the smallest anastomotic angle experienced a minimal low time-averaged wall shear stress, high oscillatory shear index and relative residence time in the anastomosis region, whereas the largest anastomotic angle can introduce more unfavorable WSS in the graft trunk. Furthermore, a spiral flow pattern was observed in the proximal graft trunk of all three models, where no high-risk shear distribution was detected in this region. CONCLUSION A smaller anastomotic angle may have more benefits of hemodynamic environment in RVR, especially the WSS distribution and flow pattern in the graft trunk. We may also suggest that additional stents or an extended cuff for the graft can be used to induce spiral flow intentionally, which can further improve local hemodynamic environment and long-term prognosis.
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Bondarenko PB, Shlomin VV, Shloĭdo EA, Puzdriak PD, Gordeev ML, Gusinskiĭ AV, Fionik OV. [Endovascular and hybrid treatment of thoracic and thoracoabdominal aortic aneurysms and dissections]. ANGIOLOGII︠A︡ I SOSUDISTAI︠A︡ KHIRURGII︠A︡ = ANGIOLOGY AND VASCULAR SURGERY 2021; 27:50-61. [PMID: 34166344 DOI: 10.33529/angio2021215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The article deals with immediate and medium-term results of hybrid and endovascular treatment of 74 patients with various pathologies of the thoracic and thoracoabdominal aorta (31 with aneurysms, 43 with thoracic and thoracoabdominal aortic dissections). Elective and emergency interventions were performed in 49 and 25 patients, respectively. Endoprosthetic repair of the arch, descending thoracic and thoracoabdominal aorta was performed in 25 patients, hybrid operations in 47 subjects (open switch of brachiocephalic, visceral and renal arteries followed by aortic endoprosthetic repair - 37, endovascular methods of making a landing zone - 12). The duration of the follow-up period after discharge from hospital amounted to 24.9±16.3 months. The technical success level was 98.6%. The overall hospital mortality rate was 11% (n=8), elective - 4% (n=2), emergency - 24% (n=6). Eight patients underwent repeat interventions on the thoracic and thoracoabdominal aorta. The 5-year cumulative survival rate was 82.3%, with freedom from repeat interventions amounting to 51.3%. Hybrid operations on the arch and descending thoracic aorta are considered to be a relatively safe and effective method of treatment. Follow-up and timely treatment of remote complications after hybrid or endovascular operations are obligatory for improving the results.
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Affiliation(s)
- P B Bondarenko
- Department of Cardiovascular Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia
| | - V V Shlomin
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - E A Shloĭdo
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - P D Puzdriak
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - M L Gordeev
- Department of Cardiovascular Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia
| | - A V Gusinskiĭ
- Department of Cardiovascular Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia
| | - O V Fionik
- Department of Cardiovascular Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia
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Gonadal vein as a bypass conduit for arterial reconstruction during an aortic debranching repair of a paravisceral aortic aneurysm. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:374-377. [PMID: 34278061 PMCID: PMC8261553 DOI: 10.1016/j.jvscit.2021.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
We report a case of a hybrid aortic debranching procedure for repair of a paravisceral inflammatory aortic aneurysm. Vein grafts were chosen over prosthetics because of concern for infection as a possible etiology. The gonadal vein was successfully used as a vein graft between the right common iliac artery and the right renal artery before aortic endograft placement.
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Shlomin VV, Grebenkina NI, Shloĭdo EA, Bondarenko PB, Puzdriak PD, Drozhzhin IG, Karpov IA, Vedernikova ES, Kositsyna IM. [Open prosthetic repair of descending aortic aneurysm after its primary endoprosthetic repair]. ANGIOLOGIIA I SOSUDISTAIA KHIRURGIIA = ANGIOLOGY AND VASCULAR SURGERY 2021; 27:131-137. [PMID: 35050258 DOI: 10.33529/angio2021415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Presented in the article is a clinical case report regarding management of an 82-year-old female patient with late complications after staged treatment for an aneurysm of the descending and abdominal portions of the aorta, with the first stage consisting in endoprosthetic repair of the descending aortic portion and the second stage (after 4 months) in endoprosthetic repair of the abdominal aortic portion. Outpatient computed tomography performed 9 months after endoprosthetic repair of the abdominal aorta revealed an increase in aortic diameter over the distance between two stent grafts in the thoracic and abdominal aortic portions from 44 mm to 76 mm. In May 2019, a repeat operation was performed: resection of the aneurysm of the distal portion of the descending aorta on temporary subclavian-femoral and prosthesis-femoral shunts, with dissection of part of the thoracic stent graft, followed by formation of a proximal anastomosis between the endoprosthesis and a 30-mm linear Dacron prosthesis, and a distal anastomosis above the celiac trunk. The woman was discharged on POD 16. Follow-up computed tomography performed 8 months later demonstrated a type II endoleak from the inferior mesenteric artery and growth of the abdominal aortic aneurysm, thus requiring embolization of the ostium of the inferior mesenteric artery via the system of the superior mesenteric artery, with a good clinical effect and a decrease in the diameter of the aortic abdominal aneurysm.
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Affiliation(s)
- V V Shlomin
- Municipal Multimodality Hospital #2, St. Petersburg, Russia
| | | | - E A Shloĭdo
- Municipal Multimodality Hospital #2, St. Petersburg, Russia
| | - P B Bondarenko
- Department of Cardiovascular Surgery, V.A. Almazov National Medical Research Centre of the RF Ministry of Public Health, St. Petersburg, Russia
| | - P D Puzdriak
- Municipal Multimodality Hospital #2, St. Petersburg, Russia
| | - I G Drozhzhin
- Municipal Multimodality Hospital #2, St. Petersburg, Russia
| | - I A Karpov
- Municipal Multimodality Hospital #2, St. Petersburg, Russia
| | | | - I M Kositsyna
- Municipal Multimodality Hospital #2, St. Petersburg, Russia
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7
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Patrick RJ, Gent S, Suess T, Bares V, VandenHull A, Pohlson K, Steffen K, Kelly PW. Combination of mural thrombus and age improves the identification of all-cause mortality following branched endovascular repair. J Vasc Surg 2020; 73:426-432.e2. [PMID: 32640319 PMCID: PMC8022350 DOI: 10.1016/j.jvs.2020.06.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/02/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND In-hospital and 30-day mortality rates of endovascular repair of thoracoabdominal aortic aneurysms shows a significant improvement over open surgery, although we are not seeing a significant difference at 1 year. We assess the hypothesis that a greater mural thrombus ratio within the aorta could function as an indicator of postoperative mortality. METHODS The mural thrombus ratio and preoperative comorbidities of 100 consecutive patients from a single center undergoing endo-debranching between 2012 and 2019 were evaluated. Logistic regression, survival analysis, and decision tree methods were used to examine each variable's association with death at 1 year. RESULTS At the time of analysis, 73 subjects had 1-year outcomes and adequate imaging to assess the parameters. At 1 year, the overall survival for all subjects was 71.2% (21 died, 52 survived). For patients with a favorable mural thrombus ratio (n = 36), the overall 1-year survival was 86.1% (5 died, 31 survived). The subjects with an unfavorable mural thrombus ratio (n = 37), had an overall 1 year survival of 56.8% (16 died, and 21 survived). The only preoperative mortality factor that was statistically significant between the subjects with an unfavorable mural thrombus ratio was age of the patient. The survival for subjects 75 years and older with an unfavorable mural thrombus ratio was 90% (one died, nine survived) vs only 44.4% survival for subjects less than 75 years with an unfavorable mural thrombus ratio (15 died, 12 survived). CONCLUSIONS This study examined whether a patient's mural thrombus ratio may be an indicator of 1-year survival. These findings suggest that the combination of a patient's aortic mural thrombus ratio and age can function as a preoperative indicator of their underlying cardiac reserve. Identifying patients with low cardiac reserve and fitness to handle the increased cardiac demands owing to the physiologic response to extensive aortic stent grafting before undergoing aortic repair may allow for modification of preoperative patient counseling and postoperative care guidelines to better treat this patient population.
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Affiliation(s)
- Ryan J Patrick
- Sanford School of Medicine, University of South Dakotal, Sioux Falls, SDak University of South Dakota School of Medicine, Vermillion, SD
| | - Stephen Gent
- Department of Mechanical Engineering, South Dakota State University, Brookings, SDak
| | - Taylor Suess
- Department of Mechanical Engineering, South Dakota State University, Brookings, SDak
| | | | | | | | - Kelly Steffen
- Department of Cardiology, Sanford Cardiovascular Institute, Sanford Health, Sioux Falls, SDak
| | - Patrick W Kelly
- Department of Vascular Surgery, Sanford Vascular Associates, Sanford Health, Sioux Falls, SDak.
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Georgiadis GS, Koutsoumpelis A, Tsilimparis N. Commentary: Physician-Modified Fenestrated/Branched EVAR and Hybrid Techniques for Acute Thoracoabdominal Aortic Pathologies: Inequality When Comparing Alternative Options With Different Philosophies Does Not Equal Lower Quality. J Endovasc Ther 2020; 27:757-763. [PMID: 32580674 DOI: 10.1177/1526602820934469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- George S Georgiadis
- Department of Vascular Surgery, "Democritus" University of Thrace, University General Hospital of Evros, Alexandroupolis, Greece
| | - Andreas Koutsoumpelis
- Department of Vascular Surgery, "Democritus" University of Thrace, University General Hospital of Evros, Alexandroupolis, Greece
| | - Nikolaos Tsilimparis
- Department of Vascular Surgery, Ludwig-Maximilians-University Hospital, Munich, Germany
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Alternative Debranching in Patients with Thoracoabdominal Aortic Aneurysm after Open and Endovascular Aortic Aneurysm Repair. Ann Vasc Surg 2019; 57:272.e1-272.e4. [PMID: 30684616 DOI: 10.1016/j.avsg.2018.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/01/2018] [Accepted: 10/08/2018] [Indexed: 11/21/2022]
Abstract
Management of recurrent thoracoabdominal aneurysmal disease of the aorta is challenging. We report three patients with previous endovascular or open aortic repair requiring redo repair by treatment by stent-graft implantation of the thoracoabdominal aorta and visceral debranching using an antegrade inflow from the ascending aorta. All three interventions were successful, with two patients alive 5 and 2 years, respectively, after this operation, while the third patient died 2 days after the procedure due to cardiac failure. No paraplegia was observed. As complications from complex open and endovascular procedures are increasing, vascular surgeons should get familiar with alternative management options.
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Shlomin VV, Korovin IV, Drozhzhin IG, Bondarenko PB, Puzdriak PD, Belousov EI, Kuz'min NV. [Elimination of late endoleak after endovascular repair of a dissecting thoracoabdominal aortic aneurysm]. ANGIOLOGIIA I SOSUDISTAIA KHIRURGIIA = ANGIOLOGY AND VASCULAR SURGERY 2019; 25:173-180. [PMID: 31855215 DOI: 10.33529/angio2019413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Described herein is a clinical case report regarding treatment of a 70-year-old male patient presenting with a late complication following endoprosthetic repair for a Stanford type B dissecting thoracic aortic aneurysm. The man was admitted to our hospital for persistent type IIb endoleak and an increased diameter of the aorta in its thoracic and thoracoabdominal portions. Two years previously, he had endured endoprosthetic repair of the thoracic aorta. The findings of computed tomography revealed negative dynamics manifesting as an increase in the diameter of the false channel of the arch and descending thoracic aorta with persistent type IIb endoleak. He was subjected to elimination of abdominal aortic dissection and type IIb endoleak with partial prosthetic repair of the descending thoracic portion of the aorta by means of prosthetic repair of the lower thoracic portion of the aorta between the stent graft and linear vascular Dacron prosthesis. The postoperative period was complicated by transient acute renal failure and paraparesis of the lower limbs. The patient was discharged on POD 14, with no endoleaks revealed on control computed tomography 3 months thereafter.
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Affiliation(s)
- V V Shlomin
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - I V Korovin
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - I G Drozhzhin
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - P B Bondarenko
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - P D Puzdriak
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
| | - E Iu Belousov
- Saint Petersburg Research Institute of Emergency Medicine named after I.I. Dzhanelidze, Saint Petersburg, Russia
| | - N V Kuz'min
- Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia
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Laux ML, Erb M, Hoelschermann F, Albes JM. Successful Surgical Abdominal Aortic Debranching Preceding Stent Graft Implantation: A Case Report. Thorac Cardiovasc Surg Rep 2018; 7:e24-e26. [PMID: 29977734 PMCID: PMC6023716 DOI: 10.1055/s-0038-1660834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/02/2018] [Indexed: 11/17/2022] Open
Abstract
Background
Acute endovascular aneurysm repair with stent grafts (thoracic endovascular aortic repair [TEVAR]) is safe and feasible.
Case Description
A 64-year-old female presented with a perforated aortic aneurysm of the thoracic descending aorta. Primary TEVAR resulted in good management of the perforation but a type Ib endoleakage remained postoperatively. To place another stent, abdominal debranching with saphenous vein bypass to the celiac trunk was required. In the same session, another endograft was inserted successfully.
Conclusion
Abdominal debranching is a safe alternative to open aortic repair in acute thoracic and abdominal aneurysms, instead of waiting for a custom-made device.
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Affiliation(s)
- Magdalena L Laux
- Department of Cardiovascular Surgery, Brandenburg Heart Center, University Hospital, Brandenburg Medical School Theodor Fontane, Bernau, Germany
| | - Michael Erb
- Department of Cardiovascular Surgery, Brandenburg Heart Center, University Hospital, Brandenburg Medical School Theodor Fontane, Bernau, Germany
| | | | - Johannes M Albes
- Department of Cardiovascular Surgery, Brandenburg Heart Center, University Hospital, Brandenburg Medical School Theodor Fontane, Bernau, Germany
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Tsilimparis N, Debus SE, Biehl M, Spanos K, Larena-Avellaneda A, Wipper S, Rohlffs F, Kölbel T. Fenestrated-branched endografts and visceral debranching plus stenting (hybrid) for complex aortic aneurysm repair. J Vasc Surg 2018; 67:1684-1689. [DOI: 10.1016/j.jvs.2017.09.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 09/25/2017] [Indexed: 10/17/2022]
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13
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Quinones-Baldrich WJ, Saleem T, Oskowitz A. Infrarenal aortic repair with or without false lumen intentional placement of endografts for hybrid management of complex aortic dissection. J Vasc Surg 2018; 68:46-54. [PMID: 29398314 DOI: 10.1016/j.jvs.2017.10.078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/21/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Aortic dissection (AD) often involves the infrarenal aorta. We review our experience with open infrarenal aortic repair with or without false lumen intentional placement (FLIP) of endografts in the proximal dissected aorta as part of a hybrid strategy to treat complex AD. METHODS A prospectively maintained database of patients undergoing intervention for AD was reviewed. Data regarding diagnosis, imaging features, nature of the infrarenal repair (one- vs two-stage procedure), endoleaks, need for additional interventions, morbidity, and mortality were collected. RESULTS Between 2006 and 2017, there were 16 patients with AD with thoracoabdominal aortic aneurysm (TAAA), malperfusion, or both who underwent open infrarenal aortic repair or replacement combined with endovascular repair in a single- or multiple-stage procedure. Fifteen patients had a chronic AD and one patient had an acute AD. The most common indication for intervention was absolute size or rapid growth of the abdominal, thoracic, or thoracoabdominal aortic aneurysm (65%). In four patients with AD, the infrarenal replacement surgical graft was used as a common distal seal zone, allowing FLIP of an endograft to treat the proximal AD. Ten (62%) cases were done in two or more stages. Three patients had infrarenal aortic replacement with debranching only. In two of these patients, the proximal dissected aorta has remained stable without aneurysmal degeneration. One patient died as a result of rupture of his aneurysm while awaiting the second stage (perioperative mortality, 6%). Patients were observed from 1 month to 7 years. One patient had a stable type II endoleak, and one patient required subsequent replacement of ascending aortic arch for aneurysmal disease. One patient died of unrelated causes on follow-up. CONCLUSIONS Hybrid infrarenal aortic repair for treatment of complex AD can be performed with low morbidity and mortality and excellent medium-term results. This strategy can resolve malperfusion while simultaneously creating a landing zone using the false lumen as the conduit for the stent graft (FLIP) in selected patients. The FLIP technique allows full expansion of the endograft, potential preservation of lumbar and intercostal artery flow, and exclusion of the weaker false lumen while, in some cases, decompressing and thus stabilizing the proximal dissected aorta.
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Affiliation(s)
| | - Taimur Saleem
- Division of Vascular Surgery, University of California at Los Angeles Medical Center, Los Angeles, Calif
| | - Adam Oskowitz
- Division of Vascular Surgery, University of California at Los Angeles Medical Center, Los Angeles, Calif
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Redo Thoracoabdominal Aortic Aneurysm Repair: A Single-Center Experience Over 25 Years. Ann Thorac Surg 2017; 103:1421-1428. [DOI: 10.1016/j.athoracsur.2016.09.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 08/01/2016] [Accepted: 09/06/2016] [Indexed: 11/18/2022]
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Hybrid Endovascular Repair of a Right-Sided Thoracoabdominal Aortic Aneurysm. Ann Thorac Surg 2017; 103:e437-e440. [PMID: 28431720 DOI: 10.1016/j.athoracsur.2016.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/05/2016] [Indexed: 11/20/2022]
Abstract
A right-sided thoracoabdominal aortic aneurysm involving a right-sided aortic arch is extremely rare. Surgical treatment for a right-sided thoracoabdominal aortic aneurysm is challenging due to the anatomical complexity. We report a case of a right-sided thoracoabdominal aortic aneurysm with a right-sided aortic arch successfully treated by hybrid visceral debranching and endovascular repair.
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