Document Detail


Endovascular repair of ascending aortic pseudoaneurysm: technical considerations of a common carotid artery approach using the Zenith aortic cuff endograft.
MedLine Citation:
PMID:  18052591     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To present a technique for endovascular treatment using Zenith aortic cuff extenders delivered via a left common carotid artery (CCA) approach in a patient with a large symptomatic ascending aortic pseudoaneurysm. CASE REPORT: A 78-year-old man with recent stroke developed worsening exertional dyspnea and chest pain 4 years following coronary artery bypass grafting. Imaging demonstrated a bovine arch and an 8-x12-cm ascending aortic pseudoaneurysm that was compressing the pulmonary arteries. The treatment strategy was to deliver a Zenith aortic cuff to seal the ascending aortic pseudoaneurysm via a left CCA approach. With the patient under general anesthesia, the left CCA was exposed and a transverse arteriotomy was made to introduce the Zenith aortic cuff sheath; the distal CCA was clamped to prevent catheter-related embolization. With its nosecone removed, a 32-x36-mm Zenith aortic cuff was delivered to the ascending aorta via the left CCA and positioned under transient cardiac arrest initiated with intravenous adenosine. A total of 3 Zenith aortic cuffs were placed in the ascending aorta to successfully exclude the pseudoaneurysm. The patient tolerated the procedure well; follow-up imaging showed successful pseudoaneurysm exclusion without endoleak. CONCLUSION: Ascending aortic pseudoaneurysm is a formidable clinical challenge due in part to the significant operative stress in a conventional surgical repair, as well as limited endovascular treatment options. Because there are no approved endovascular devices for ascending aortic aneurysm repair, clinicians may have to rely on endograft components designed for abdominal aortic aneurysms to treat lesions in the ascending aorta.
Authors:
Peter H Lin; Panagiotis Kougias; Tam T Huynh; Joseph Huh; Joseph S Coselli
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  14     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  794-8     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. plin@bcm.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, False / etiology,  radiography,  surgery*
Aortic Aneurysm / etiology,  radiography,  surgery*
Aortography
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / instrumentation,  methods*
Carotid Artery, Common / radiography,  surgery*
Coronary Artery Bypass / adverse effects*
Humans
Iatrogenic Disease*
Male
Patient Selection
Prosthesis Design
Radiography, Interventional
Stents*
Surgical Procedures, Minimally Invasive
Tomography, X-Ray Computed
Treatment Outcome
Comments/Corrections
Comment In:
J Endovasc Ther. 2007 Dec;14(6):799-800   [PMID:  18052592 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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