title: Endovascular exclusion of a thoracoabdominal aortic aneurysm after retrograde visceral artery revascularization.
abstract: 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.
authors.affiliation: 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
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.forename: Kamal
authors.initials: K
authors.lastname: Gupta
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.forename: Gregor
authors.initials: G
authors.lastname: Poglajen
authors.forename: Nina
authors.initials: N
authors.lastname: Suvorov
authors.forename: Kathy G
authors.initials: KG
authors.lastname: Dougherty
authors.forename: Zvonimir
authors.initials: Z
authors.lastname: Krajcer
mesh_terms: 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*