| Endovascular repair of a ruptured descending thoracic aortic aneurysm in a patient with an ascending aortic aneurysm: hybrid open arch reconstruction with simultaneous thoracic stent-graft deployment within elephant trunk. | |
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MedLine Citation:
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PMID: 18346569 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Endovascular repair of the thoracic aorta is now widely practiced. The extension of this technique to emergent settings is in evolution. Pathology of the ascending and transverse aortic arch may preclude thoracic aortic stent grafting due to the lack of a proximal seal zone. Several hybrid open/endovascular approaches have been described. We recently encountered the difficult case of a contained rupture of a 6.8 cm descending thoracic aortic aneurysm in a 60-year-old patient with aneurysmal degeneration of the ascending and transverse aortic arch. This patient was treated with a hybrid approach of open ascending and transverse arch reconstruction along with simultaneous stent-graft repair of the descending thoracic aorta. The open repair established an excellent proximal landing zone by use of the "elephant trunk" technique. This technique also allowed direct suture fixation of the stent graft to the arch graft to prevent stent-graft migration. This hybrid surgical approach was successful and avoided the cumulative morbidity that a left thoracoabdominal approach would have added to the sternotomy. Further creative uses of these hybrid techniques will undoubtedly serve a larger role in the treatment of thoracic aortic pathology. |
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Authors:
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Ahmed M Abou-Zamzam; Wayne Zhang; Nan Wang; Anees Razzouk |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Annals of vascular surgery Volume: 22 ISSN: 0890-5096 ISO Abbreviation: Ann Vasc Surg Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-18 Completed Date: 2008-07-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 168-72 Citation Subset: IM |
Affiliation:
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Division of Vascular Surgery, Department of Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA. aabouzamzam@ahs.llumc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aortic Aneurysm, Thoracic
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radiography,
surgery* Aortic Rupture / radiography, surgery* Blood Vessel Prosthesis Implantation* / methods Emergencies Humans Male Middle Aged Stents* Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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