title: Hybrid endovascular repair of a dissecting thoracoabdominal aortic aneurysm with stent graft implantation through the false lumen.
abstract: We report the first successful hybrid endovascular technique for treating a residual dissecting thoracoabdominal aortic aneurysm with a compressed true lumen in a 48-year-old man in whom multiple stent grafts were deployed through the false lumen. The first stage of the procedure involved debranching of the visceral vessels from the right external iliac artery. In the second stage, a Gore excluder iliac extender (W. L. Gore and Associates, Flagstaff, Ariz) was deployed through the false lumen of the left common iliac artery; then, a Powerlink bifurcated stent graft (Endologix, Irvine, Calif) was positioned at the false lumen of the abdominal aorta. Overlapping with this stent graft, three Gore TAG stent grafts were deployed upward toward the Dacron (DuPont, Wilmington, Del) graft implanted during a previous operation on the descending aorta. Subsequently, the patient had an uneventful postoperative course, with no complications at the 3-year follow-up. The successful results of our new hybrid endovascular technique suggest the feasibility and efficacy of stent graft implantation through the false lumen.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kuratani
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Shirakawa
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Torikai
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimamura
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: sawa@surg1.med.osaka-u.ac.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome