Document Detail


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.
MedLine Citation:
PMID:  18346569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ahmed M Abou-Zamzam; Wayne Zhang; Nan Wang; Anees Razzouk
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  22     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-18     Completed Date:  2008-07-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-72     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Department of Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA. aabouzamzam@ahs.llumc.edu
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MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm, Thoracic / 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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