title: Hybrid Procedure with Debranching from the Descending Aorta for Aortic Arch Aneurysm after Previous Open Repair.
abstract: Aortic arch aneurysms can be treated with hybrid procedures by endovascular exclusion and prior debranching of supra-aortic arteries. We report on a case of symptomatic arch aneurysm following previous supracoronary ascending aorta and hemiarch replacement with a very short proximal landing zone. A successful reconstruction was performed by retrograde revascularization of supra-aortic vessels from the descending aorta and subsequent endovascular repair deploying a proximal stent graft directly above the sinotubular junction with good results in the 4-year follow-up. Retrograde supra-aortic debranching may constitute a suitable approach for hybrid endovascular repair of aneurysms of the aortic arch and the ascending aorta in selected cases.
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany. Electronic address: juergen.zanow@med.uni-jena.de.
authors.forename: Juergen
authors.initials: J
authors.lastname: Zanow
authors.affiliation: Department of Heart and Thoracic Surgery, Jena University Hospital, Jena, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Breuer
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Lopatta
authors.affiliation: Department of Anaesthesiology, Jena University Hospital, Jena, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schelenz
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany.
authors.forename: Utz
authors.initials: U
authors.lastname: Settmacher
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D003131:Combined Modality Therapy; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome