Document Detail


Extra-anatomic bypass for recurrent abdominal aortic and renal in-stent stenoses following radiotherapy for neuroblastoma.
MedLine Citation:
PMID:  19126553     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe the case of an 11-year-old girl with an abdominal neuroblastoma which was operated and intraoperatively irradiated nine years ago. After six years, she developed stenoses of the infrarenal abdominal aorta and both renal arteries. Initial treatment of the stenosed vessels comprised endovascular balloon dilatations and repeated stent-graft implantations, including drug eluting stents. However, severe in-stent stenoses occurred during follow-up and the girl developed acute renal failure. Open surgery was performed with two extra-anatomic bypasses, a thoracic-to-abdominal aortic bypass and a left iliac-to-renal bypass, on an urgent basis. The postoperative course was uneventful and the patient was discharged home two weeks after the operation with full recovery of renal function. We conclude that endovascular stent-graft placement in children can only be a palliative treatment due to outgrowing of the stent-graft and the potential risk of re-stenosis, especially after a history of irradiation. Vascular surgery with placement of extra-anatomic bypasses will provide a definite treatment.
Authors:
Maximilian Luehr; Matthias Siepe; Friedhelm Beyersdorf; Christian Schlensak
Related Documents :
9626433 - Determination of stent stenosis: an in vivo experimental comparison of intravascular ul...
12552533 - Initial multicenter experience with a novel distal protection filter during carotid art...
21912373 - Accurate and simple evaluation of vascular anastomoses in monochorionic placenta using ...
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-01-06
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  8     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-23     Completed Date:  2009-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  488-90     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, University Medical Center Freiburg, Freiburg, Germany. mail@dr-luehr.net
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abdominal Neoplasms / radiotherapy*,  surgery
Angiography, Digital Subtraction
Angioplasty, Balloon / instrumentation*
Aorta, Abdominal / radiography,  surgery*
Aorta, Thoracic / surgery
Aortic Diseases / etiology,  radiography,  surgery,  therapy*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / instrumentation
Child
Constriction, Pathologic
Drug-Eluting Stents*
Female
Humans
Iliac Artery / surgery
Kidney Failure, Acute / etiology,  surgery
Neuroblastoma / radiotherapy*,  surgery
Palliative Care
Radiation Injuries / etiology,  radiography,  surgery,  therapy*
Radiotherapy / adverse effects
Recurrence
Renal Artery Obstruction / etiology,  radiography,  surgery,  therapy*
Tomography, X-Ray Computed
Treatment Outcome

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


Previous Document:  The bilateral pulmonary artery banding for hypoplastic left heart syndrome with a diminutive ascendi...
Next Document:  OCT4 expression in human non-small cell lung cancer: implications for therapeutic intervention.