title: Thoracic endovascular aortic repair with visceral arteries intermittent clamp technique for descending thoracic aortic aneurysm with shaggy aorta.
abstract: Aortic repair for severely atheromatous aneurysm remains a challenge. We used an intermittent clamp technique for all visceral arteries during thoracic endovascular aortic repair (TEVAR) for a thoracic aortic aneurysm with a "shaggy aorta" to prevent systemic thromboembolism. In addition, we applied an extracorporeal circulation circuit to trap the thrombi during the endovascular repair. Postoperatively, no embolic complications were seen, and microscopic examination showed trapped plaques on the filter. We conclude that this technique is an option for preventing thromboembolism in aortic aneurysm repair in the context of a shaggy aorta when substantial concern of distal diffuse atheromatous emboli is raised based on clinical history or clear evidence on imaging.
authors.affiliation: Department of Cardiovascular Surgery, Fukushima Medical University, School of Medicine, Fukushima, Japan. igao5150@fmu.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Igarashi
authors.forename: Shinya
authors.initials: S
authors.lastname: Takase
authors.forename: Hirono
authors.initials: H
authors.lastname: Satokawa
authors.forename: Yukitoki
authors.initials: Y
authors.lastname: Misawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Wakamatsu
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D003082:Colectomy; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery; D003250:Constriction; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014781:Viscera / Q000098:blood supply*