Repair of type IV thoracoabdominal aneurysm with a combined endovascular and surgical approach.

Abstract:

:We report an unusual case of type IV Thoracoabdominal Aneurysm (TAA) with Superior Mesenteric Artery (SMA), celiac artery, and bilateral renal artery aneurysms in a patient who underwent an earlier repair of two infrarenal Abdominal Aortic Aneurysm (AAA) ruptures. Because of the presence of the visceral artery aneurysms and the earlier operation through the retroperitoneum, standard surgical treatment via a retroperitoneal approach with an inclusion grafting technique was considered difficult. A combined surgical approach achieving retrograde perfusion of all four visceral vessels and endovascular grafting allowing exclusion of the TAA was accomplished. Complete exclusion of the aneurysm and normal perfusion of the patient's viscera was documented by means of follow-up examinations at 3 and 6 months. The repair of a type IV TAA with a Combined Endovascular and Surgical Approach (CESA) allowed us to manage both the aortic and visceral aneurysms without thoracotomy or re-do retroperitoneal exposure and minimized visceral ischemia time. If the durability of this approach is confirmed, it may represent an attractive alternative in patients with aneurysmal involvement of the visceral segment of the aorta.

journal_name

J Vasc Surg

authors

Quiñones-Baldrich WJ,Panetta TF,Vescera CL,Kashyap VS

doi

10.1016/s0741-5214(99)70084-4

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

555-60

issue

3

eissn

0741-5214

issn

1097-6809

pii

S0741521499002955

journal_volume

30

pub_type

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