[Vascular bypass grafting combined with endovascular aortic repair for treatment of aortic dilatation disease].
OBJECTIVE
To summarize the clinical experience of vascular bypass grafting combined with endovascular aortic repair (EVAR) for aortic dilatation disease.


METHODS
Between January 2008 and August 2011, 12 patients with aortic dilatation disease were treated with vascular bypass grafting combined with EVAR. Of 12 patients, 11 were male and 1 was female, aged 47-81 years (mean, 65.9 years). All cases were diagnosed through computed tomography angiography (CTA), including 1 case of Stanford type A dissection, 5 cases of Stanford type B dissection, 4 cases of aortic arch aneurysm, and 2 cases of abdominal aortic aneurysm. Eight patients received neck artery bypass grafting before EVAR, and 4 patients underwent femoral artery bypass grafting after EVAR.


RESULTS
After operation, pulmonary infection occurred in 3 patients, renal insufficiency in 2 patients, cerebral infarction in 1 case, decreased hemoglobin and platelets in 7 cases, and poor healing of groin wound in 1 case. Eleven patients were followed up 3-42 months, with an average of 18.6 months. In 1 case undergoing EVAR of the thoracic and abdominal aorta, EVAR was performed again because new aneurysms formed at 6 months after operation, and the patient achieved good recovery after 3 months. CTA showed reduced false lumen, thrombosis formation, no endoleak, no deformation or displacement of stent, and anastomotic patency of artificial blood vessels in the other patients at 3, 6, and 12 months after operation.


CONCLUSIONS
Vascular bypass grafting combined with EVAR can expand the indications for endovascular repair. It not only provides sufficient anchoring area, but also ensures the blood supply to vital organs, simplifies the surgical procedure, and reduces the difficulty of endovascular treatment.
Institute of Cardiothoracic Surgery of Fujian Province & Department of Cardiac Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou Fujian 350001, PR China.
Zhenlong
Z
Zhang
Hanfan
H
Qiu
Liangwan
L
Chen
Daozhong
D
Chen
Xueshan
X
Huang
Hua
H
Cao
Feng
F
Lin
Zhongyao
Z
Huang
D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002339:Carotid Arteries / Q000601:surgery; D001026:Coronary Artery Bypass / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome