Lengthening of proximal implantation site during endovascular repair of thoracic aortic aneurysm: preservation of carotid patency with retrograde trans endograft deployment of a carotid stent.
Endovascular repair of descending thoracic aortic aneurysms with a reduced proximal implantation site represents a technical challenge. Surgical procedures before endovascular exclusion can be necessary to increase the length of the proximal landing site to avoid type 1 endoleaks. We present a case of endovascular exclusion of a descending thoracic aortic aneurysm with the endograft placed proximal to the left common carotid artery. Flow to this arch was preserved reconstructing the carotid ostium with the retrograde implantation of a carotid stent that was placed extending across an orifice created in the deployed endograft by puncture and balloon dilatation.
Eid-Lidt
Guering
G
Department of Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. guering@yahoo.com
Ramirez
Samuel
S
Gaspar
Jorge
J
D000328:Adult; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D017536:Carotid Artery, Common / Q000601:surgery*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery; D014654:Vascular Patency