Endovascular exclusion of a thoracoabdominal aortic aneurysm after retrograde visceral artery revascularization.
Historically, open surgical repair of thoracoabdominal aortic aneurysms has been associated with high morbidity and mortality rates. Furthermore, endovascular exclusion alone can restrict blood flow to visceral arteries. We report a case of thoracoabdominal aortic aneurysm that was repaired using a hybrid approach: surgery followed by an endovascular procedure. A 53-year-old woman was admitted to our hospital for endovascular exclusion of a thoracoabdominal aortic aneurysm that included the superior mesenteric artery and the celiac artery. Aorto-mesenteric and aorto-celiac artery bypass grafting was performed to create a landing zone for subsequent endovascular exclusion of the aneurysm, which was completed successfully 6 weeks after the bypass procedure. For thoracoabdominal aortic aneurysms that extend beyond the superior mesenteric artery and the celiac or renal arteries, a hybrid approach, consisting of limited surgical treatment followed by endovascular exclusion of the aneurysm, may yield optimal results in selected patients with serious preoperative comorbidities.
Gregoric
Igor D
ID
The Department of Cardiovascular Surgery, the Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA. knowlin@heart.thi.tmc.edu
Gupta
Kamal
K
Jacobs
Michael J
MJ
Poglajen
Gregor
G
Suvorov
Nina
N
Dougherty
Kathy G
KG
Krajcer
Zvonimir
Z
D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D003097:Collateral Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D014656:Vascular Surgical Procedures / Q000379:methods*