Document Detail


Hybrid-procedures for the treatment of thoracoabdominal aortic aneurysms and dissections.
MedLine Citation:
PMID:  17056286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The conventional open repair of thoracoabdominal aneurysms and dissections remains complex and demanding and is associated with significant morbidity and mortality. We present our experience of hybrid open and endovascular treatment of thoracoabdominal aneurysms and dissections. METHODS: Within an experience of 226 aortic stent-grafts between 1998 and April 2006, 6 of the patients (median age 60 years, range 35 to 68 years) with thoracoabdominal aneurysms (Crawford type I, II, III, and V) were treated with a combined endovascular and open surgical approach. Five men and one woman, with median aneurysm diameter of 75 mm (range 70-100 mm), received revascularization of the renal arteries, the superior mesenteric artery, and the coeliac trunk accomplished via transperitoneal bypass grafting. Aneurysmal exclusion was then performed by stent-graft deployment. RESULTS: The entire procedure was technically successful in all patients. The patients were discharged a median of 9 days after the operation, while the postoperative studies revealed the patency of the vessels and no evidence of type I endoleak or secondary rupture of the aneurysm. During follow up (1 to 22 months) spiral-CT scanning revealed distinct shrinkage of the aneurysm, no graft migration or endoleak and patency of all revascularised vessels, except one renal artery in two patients. No patient experienced any temporary or permanent neurological deficit, and no dialysis was necessary. CONCLUSION: The combined endovascular and open surgical approach is feasible, without cross clamping of the aorta and with minimized ischemia time for renal and visceral arteries, and seems to be an appropriate strategy for patients with a thoraco-abdominal aortic aneurysm or dissection.
Authors:
M Gawenda; M Aleksic; J Heckenkamp; V Reichert; A Gossmann; J Brunkwall
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Publication Detail:
Type:  Journal Article     Date:  2006-10-23
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  33     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-02-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  71-7     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Medical Centre, University of Cologne, Cologne, Germany. michael.gawenda@medizin.uni-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Dissecting / physiopathology,  radiography,  surgery*
Angioplasty*
Aortic Aneurysm, Abdominal / physiopathology,  radiography,  surgery*
Aortic Aneurysm, Thoracic / physiopathology,  radiography,  surgery*
Celiac Artery / surgery
Female
Follow-Up Studies
Humans
Male
Mesenteric Artery, Superior / surgery
Middle Aged
Radiography, Interventional
Renal Artery / surgery
Severity of Illness Index
Time Factors
Tomography, Spiral Computed
Treatment Outcome
Vascular Patency
Vascular Surgical Procedures / methods*

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


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