Simultaneous open and endoluminal repair of ruptured abdominal and thoracic aortic aneurysms: report of a case.
A 66-year-old woman was transferred to our hospital for emergency treatment of a ruptured abdominal aortic aneurysm (AAA) and impending rupture of a descending thoracic aortic aneurysm (TAA) caused by a Stanford type-B dissection. She had severe coronary artery disease and a highly calcified aorta, and had been taking long-term steroids for rheumatoid arthritis. Endovascular repair of the TAA failed because the femoral artery was too small, so we performed simultaneous repair of the TAA and the AAA. A temporary axillofemoral bypass was constructed and the AAA was replaced with a bifurcated prosthetic graft. A thoracic stent graft was delivered successfully through a chimney graft of the abdominal graft. About 4 months later, the TAA extended proximally, causing hemoptysis, which was stopped by placing a new stent graft proximal to the previous one. This case report shows that a combination of open and endovascular repair is useful for treating a TAA with an AAA, especially in a small or frail patient.
Sugimoto
Ikuo
I
Department of Vascular Surgery, Aichi Medical University, 21 Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi 480-1195, Japan.
Ohta
Takashi
T
Ishibashi
Hiroyuki
H
Kawanishi
Jun
J
Yamada
Tetsuya
T
Nihei
Toshiki
T
Hosaka
Minoru
M
Ishiguchi
Tsuneo
T
D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D017130:Angioplasty / Q000379:methods; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods