title: Use of a surgeon-modified branched thoracic endograft to preserve an aortorenal bypass during treatment of an intercostal patch aneurysm.
abstract: A 72-year-old man presented with thoracic pain. Nine years earlier, a descending aortic dissection with aneurysmal degeneration had been treated by thoracoabdominal aortic graft placement with reimplantation of a visceral patch and an intercostal patch. A separate left aortorenal bypass had also been performed with the bypass originating from the thoracic portion of the graft. He now presents with a 7.2-cm intercostal patch aneurysm in the aortic segment containing the origin of the patent aortorenal bypass. We present the use of a surgeon-modified branched thoracic endograft to salvage an aortorenal bypass originating in a thoracic aneurysm after previous open thoracoabdominal aortic aneurysm repair.
authors.affiliation: Department of Surgery, Section of Vascular Surgery, Washington University School of Medicine, St Louis, Mo 63110, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Jim
authors.forename: Luis A
authors.initials: LA
authors.lastname: Sanchez
authors.forename: Brian G
authors.initials: BG
authors.lastname: Rubin
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery*; D012079:Renal Circulation; D012086:Reoperation; D012092:Replantation; D015607:Stents; D013895:Thoracic Arteries / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome