Reversed sequence arch debranching for treatment of a ruptured juxta-innominate artery saccular aneurysm.

Abstract:

PURPOSE:To describe a hybrid approach for the treatment of a ruptured juxta-innominate artery saccular aneurysm. CASE REPORT:A 68-year-old smoker male with poor exercise tolerance sustained a contained ruptured saccular aneurysm at the origin of the innominate artery. Although under the femoral-axillary bypass to allow direct brain perfusion, a 36 × 110 mm thoracic endograft was successfully deployed with total coverage of the distal ascending and aortic arch. A sternotomy was performed and an aorto-innominate and left common carotid artery bypass was done. At 1-month follow-up, a type 2 endoleak at the innominate artery stump was noted and successfully treated with coil embolization. The patient remains neurologically intact 1 year after the surgery. CONCLUSION:Juxta-innominate artery saccular aneurysms are rare. A hybrid open-endovascular repair using a reversed sequence arch debranching after endovascular repair is feasible and may be an alternative to deep hypothermic circulatory arrest particularly in frail patients.

journal_name

Vasc Endovascular Surg

authors

Malgor RD,Bilfinger TV,Tassiopoulos AK

doi

10.1177/1538574412470739

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

151-4

issue

2

eissn

1538-5744

issn

1938-9116

pii

1538574412470739

journal_volume

47

pub_type

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