Direct aortic access for endovascular thoracoabdominal aneurysm repair using a bifurcated endograft as a branched device

• Published in: Journal of vascular surgery cases and innovative techniques 2023-03, Vol.9 (1), p.101056, Article 101056
• Main Authors: Lu, Jeffrey, Blitzer, David, Pereira Torrellas, Gabriel A., Hall, Michael, Kang, Jeanwan, Toursavadkohi, Shahab
• Format: Article
• Language: English
• Subjects: Aneurysm; Case report; Direct sac access; Endograft; Endovascular; EVAR; Takayasu arteritis; Vascular surgery
• ISSN: 2468-4287; 2468-4287
• DOI: 10.1016/j.jvscit.2022.10.014

Aortic aneurysms (AA) are a common complication in patients with large-vessel vasculitis, such as chronic phase Takayasu arteritis, that often require surgical management to prevent a lethal rupture. Historically, mainstay of treatment for AA in the setting of arteritis was traditional open repair. However, in this case study an alternative surgical approach was devised to successfully treat an extent III thoracoabdominal AA in a patient with a diagnosis of Takayasu arteritis and a complex surgical history that made her high risk for an open surgical intervention. This case study summarizes a hybrid surgical approach that successfully excluded a thoracoabdominal AA and revascularized the superior mesenteric artery and left renal artery, by directly accessing the infrarenal aorta and using a bifurcated abdominal aortic endograft as a two-vessel branched device.