Endovascular exclusion of a thoracoabdominal aortic aneurysm after retrograde visceral artery revascularization

Historically, open surgical repair of thoracoabdominal aortic aneurysms has been associated with high morbidity and mortality rates. Furthermore, endovascular exclusion alone can restrict blood flow to visceral arteries. We report a case of thoracoabdominal aortic aneurysm that was repaired using a...

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Bibliographic Details
Published in:Texas Heart Institute journal 2005, Vol.32 (3), p.416-420
Main Authors: Gregoric, Igor D, Gupta, Kamal, Jacobs, Michael J, Poglajen, Gregor, Suvorov, Nina, Dougherty, Kathy G, Krajcer, Zvonimir
Format: Article
Language:English
Subjects:
Aortic Aneurysm, Abdominal - complications
Aortic Aneurysm, Abdominal - diagnosis
Aortic Aneurysm, Abdominal - surgery
Aortic Aneurysm, Thoracic - complications
Aortic Aneurysm, Thoracic - diagnosis
Aortic Aneurysm, Thoracic - surgery
Aortography
Case Report
Collateral Circulation
Female
Follow-Up Studies
Humans
Magnetic Resonance Angiography
Middle Aged
Vascular Surgical Procedures - methods
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Summary:Historically, open surgical repair of thoracoabdominal aortic aneurysms has been associated with high morbidity and mortality rates. Furthermore, endovascular exclusion alone can restrict blood flow to visceral arteries. We report a case of thoracoabdominal aortic aneurysm that was repaired using a hybrid approach: surgery followed by an endovascular procedure. A 53-year-old woman was admitted to our hospital for endovascular exclusion of a thoracoabdominal aortic aneurysm that included the superior mesenteric artery and the celiac artery. Aorto-mesenteric and aorto-celiac artery bypass grafting was performed to create a landing zone for subsequent endovascular exclusion of the aneurysm, which was completed successfully 6 weeks after the bypass procedure. For thoracoabdominal aortic aneurysms that extend beyond the superior mesenteric artery and the celiac or renal arteries, a hybrid approach, consisting of limited surgical treatment followed by endovascular exclusion of the aneurysm, may yield optimal results in selected patients with serious preoperative comorbidities.
ISSN:0730-2347