Hybrid Debranching-Endovascular Repair of Visceral Patch Aneurysm After Thoracoabdominal Aneurysm Repair

Abstract

A visceral patch aneurysm is a significant complication after extensive thoracoabdominal aneurysm repair, and open procedures to correct these lesions are associated with a high perioperative mortality. We report the case of a 6-cm visceral patch aneurysm occurring in a patient with a completely replaced descending and abdominal aorta that was successfully corrected by staged debranching and endovascular repair with a dedicated thoracic endograft. Hybrid procedures are a successful option to treat complex repairs in the reoperative setting. They have the potential to lower perioperative risk and enhance patient care.

Keywords

aneurysm visceral aorta complication endovascular hybrid procedure

Get full access to this article

View all access options for this article.

References

Dardik A. , Perler BA , Roseborough GS , Williams GM Aneurysmal expansion of the visceral patch after thoracoabdominal aortic replacement: an argument for limiting patch size ? J Vasc Surg. 2001;34: 405-409 ; discussion 410 .

Tshomba Y. , Melissano G. , Civilini E. , Setacci F. , Chiesa R. Fate of the visceral aortic patch after thoracoabdominal aortic repair . Eur J Vasc Endovasc Surg. 2005;29: 383-389 .

Carrel TP , Signer C. Separate revascularization of the visceral arteries in thoracoabdominal aneurysm repair . Ann Thorac Surg. 1999;68: 573-575 .

Dias RR , Coselli JS , Stolf NA , Dias AR , Mady C. , Oliveira SA Aneurysmal dilation of the reimplant segment of the visceral vessels after thoracoabdominal aneurysm correction . Arq Bras Cardiol. 2003;81: 273-278 .

Lombardi JV , Carpenter JP , Pochettino A. , Sonnad SS , Bavaria JE Thoracoabdominal aortic aneurysm repair after prior aortic surgery . J Vasc Surg. 2003;38: 1185-1190 .

Inoue K. , Iwase T. , Sato M. , et al. Transluminal endovascular branched graft placement for a pseudoaneurysm: reconstruction of the descending thoracic aorta including the celiac axis . J Thorac Cardiovasc Surg. 1997;114: 859-861 .

Black SA , Wolfe JH , Clark M. , Hamady M. , Cheshire NJ , Jenkins MP Complex thoracoabdominal aortic aneurysms: endovascular exclusion with visceral revascularization . J Vasc Surg. 2006;43: 1081-1089 ; discussion 1089 .

Flye MW , Choi ET , Sanchez LA , et al. Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm . J Vasc Surg. 2004;39: 454-458 .

Peterson BG , Pearce WH , Resnick SA , Eskandari MK Stent-graft treatment of thoracoabdominal aortic aneurysms after complete visceral debranching . J Vasc Interv Radiol. 2006;17: 1519-1525 .

10.

Zhou W. , Reardon ME , Peden EK , Lin PH , Bush RL , Lumsden AB Endovascular repair of a proximal aortic arch aneurysm: a novel approach of supra-aortic debranching with antegrade endograft deployment via an anterior thoracotomy approach . J Vasc Surg. 2006;43: 1045-1048 .

11.

Lundbom J. , Hatlinghus S. , Aadahl P. , Myhre HO Endovascular treatment of vascular emergencies and complications following previous vascular surgery . Eur J Vasc Endovasc Surg. 2000;19: 205-209 .

12.

Juvonen T. , Biancari F. , Ylonen K. , Perala J. , Rimpilainen J. , Lepojarvi M. Combined surgical and endovascular treatment of pseudoaneurysms of the visceral arteries and of the left iliac arteries after thoracoabdominal aortic surgery . Eur J Vasc Endovasc Surg. 2001;22: 275-277 .