Document Detail


Hybrid repair of bilateral subclavian artery aneurysms in a patient with Marfan syndrome.
MedLine Citation:
PMID:  19631504     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 32-year-old man with Marfan syndrome presented with enlarging, asymptomatic bilateral subclavian artery aneurysms. He has an extensive surgical history including aortic arch and descending thoracic aorta replacement. The L aneurysm was treated first with an L carotid-vertebral artery vein bypass, aneurysm debranching, and stent-graft repair of aneurysm via the L brachial artery approach. The R aneurysm was treated by placing a stent graft from the proximal R common carotid artery across the R subclavian artery origin and landing in the prosthetic innominate bypass graft via an L common carotid artery conduit. An aneurysm debranching and R carotid-subclavian artery bypass completed the procedure. A proximal type I endoleak was detected in the R aneurysm sac on follow-up computed tomography angiography. This was treated with sternotomy, aorta to L common carotid artery bypass, stent graft removal, and oversewing of the R subclavian artery origin. The patient recovered uneventfully. Subclavian artery aneurysms are rarely diagnosed in patients with Marfan disease. Although durability remains unproven, hybrid repair should be considered in patients with subclavian artery aneurysms, to minimize the morbidity commonly associated with open repair.
Authors:
Jonathan N Bowman; Sharif H Ellozy; Konstadinos Plestis; Michael L Marin; Peter L Faries
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-07-23
Journal Detail:
Title:  Annals of vascular surgery     Volume:  24     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  114.e1-5     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Mount Sinai School of Medicine, 5 E. 98th Street, Box 1273, New York, NY 10029, USA. jonathan.bowman@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm / etiology,  radiography,  surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / instrumentation
Carotid Artery, Common / surgery
Device Removal
Humans
Ligation
Male
Marfan Syndrome / complications*
Prosthesis Failure
Reoperation
Saphenous Vein / transplantation
Stents
Sternotomy
Subclavian Artery / radiography,  surgery*
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / adverse effects,  instrumentation
Vertebral Artery / surgery

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


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