Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/jvb.2014.058
Jornal Vascular Brasileiro
Therapeutic Challenge

Two-stage hybrid open-endovascular repair of a Crawford type IV aortic aneurysm: therapeutic challenge

Tratamento híbrido (debranching) de aneurisma tóraco-abdominal tipo IV de Crawford: desafio terapêutico

Abdo Farret Neto; Liana Berucia Freire de Oliveira; Guilherme Tarso de Andrade Alves; George Anderson da Penha Andrade; Eduardo Dantas Baptista de Faria

Downloads: 0
Views: 814

Abstract

We present a case of a patient with Crawford type IV aortic thoracoabdominal aneurysm. The patient underwent hybrid repair in two stages. Initially a Dacron(r) graft was implanted surgically with revascularization of all visceral branches from the left external iliac artery (debranching). On a later date, the second stage of treatment was with an endovascular technique with bi aorto-iliac endoprosthesis. After 2 years the patient remains asymptomatic and in full working activity.

Keywords

aortic aneurysm, surgery, aorta, aneurysm

Resumo

Apresentamos o caso de um paciente com aneurisma aórtico tóraco-abdominal tipo IV de Crawford submetido à correção híbrida em dois estágios. Inicialmente submetido a implante cirúrgico de prótese de Dacron® com revascularização de todos os ramos viscerais a partir da ilíaca externa esquerda (debranching) e, posteriormente, tratado pela técnica endovascular com endoprótese aorto bi-ilíaca. Após dois anos, o paciente permanece assintomático e em plena atividade laborativa.

Palavras-chave

aneurisma aórtico, cirurgia, aorta, aneurisma

References

Patel R, Conrad MF, Paruchuri V, Kwolek CJ, Chung TK, Cambria RP. Thoracoabdominal aneurysm repair: Hybrid versus open repair. J Vasc Surg. 2009;50(1):15-22.

Wong DR, Parenti JL, Green SY. Open repair of thoracoabdominal aortic aneurysm in the modern surgical era: contemporary outcomes in 509 patients. J Am Coll Surg. 2011;212(4):569-81.

Hughes GC, Barfield ME, Shah AA. Staged total abdominal debranching and thoracic endovascular aortic repair for thoracoabdominal aneurysm. J Vasc Surg. 2012;56(3):621-9.

Patel HJ, Upchurch GR, Eliason JL. Hybrid debranching with endovascular repair for thoracoabdominal aneurysms: a comparison with open repair. Ann Thorac Surg. 2010;89(5):1475 81.

Jenkins MP. Part one: treatment of type IV thoracoabdominal aneurysms: hybrid technique with debranching is the best option. Eur J Vasc Endovasc Surg. 2011;42(1):1-4.

Quiñones-Baldrich WJ, Panetta TF, Vescera CL, Kashyap VS. Repair of type IV thoracoabdominal aneurysm with a combined endovascular and surgical approach. J Vasc Surg. 1999;30(3):555 60.

Chiesa R, Melissano G, Civilini E, Setacci F, Tshomba Y, Anzuini A. Two-stage combined endovascular and surgical approach for recurrent thoracoabdominal aortic aneurysm. J Endovasc Ther. 2004;11(3):330-3.

Pieper CC, Meyer C, Verrel F, Schild HH, Wilhelm KE. Using the multilayer stent as a supplement to EVAR in combined abdominal aortic aneurysm and iliac artery aneurysm with inadequate distal landing zone: a case report. Vasc and Endovasc Surg. 2012;46(7):565-9.

Ohrlander T, Sonesson B, Ivancev K, Resch T, Dias N, Malina M. The chimney graft: A technique for preserving or rescuing aortic branch vessels in stent-graft sealing zones. J Endovasc Ther. 2008;15(4):427-32.

Verhoeven EL, Vourliotakis G, Tielliu IF. Fenestrated Stent grafting for short-necked and justarenal abdominal aortic aneurysm: an 8-year single-centre experience. Eur J Vasc Endovasc Surg. 2010;39(5):529-36.

Amato ACM, Abraham FA, Kraide HD, Rocha LT, Santos RV. Endotensão: ruptura de aneurisma de aorta abdominal. J Vasc Bras. 2012;11(2):162-5.

Criado FJ, Duson S. The history of snorkel, chimney, periscope and sandwich grafting compared with fenestrated and branched endografting. Vascular and endovascular challlenges update. 2013:p. 449.

Huynh TT, Miller CC, Estrera AL, Sheinbaum R, Allen SJ, Safi HJ. Determinants of hospital length of stay after thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2002;35(4):648-53.

Quinones-Baldrich WJ. Descending thoracic and thoracoabdominal aortic aneurysm repair: 15 year results using a uniform approach. Ann Vasc Surg. 2004;18(3):335-42.

Roselli EE, Greenberg RK, Pfaff K, Francis C, Svensson LG, Lytle BW. Endovascular treatment of thoracoabdominal aortic aneurysms. J Thorac Cardiovasc Surg. 2007;133(6):1474-82.

Greenberg RK, Lu Q, Roselli EE. Contemporary analysis of descending thoracic and thoracoabdominal aneurysm repair: a comparison of endovascular and open techniques. Circulation. 2008;118:808-17.

Verhoeven E, Tielliu IF, Zeebregts CJ. Bericht über die ersten 50 endovaskulären thorakoabdominellen Behandlungen mit Seitenastprothesen. Zentrabl Chir. 2011;136(5):451-7.

Guillou M, Bianchini A, Sobocinski J. Endovascular treatment of thoracoabdominal aortic aneurysms. J Vasc Surg. 2012;56(1):65 73.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd84cb0e882541411da3ea jvb Articles

J Vasc Bras

Share this page
Page Sections