A novel balloon-assisted technique to secure visceral catheterization during a chimney endovascular repair of a ruptured abdominal aortic aneurysm in a centenarian patient
Abstract A 100-year-old male patient was admitted with a ruptured abdominal aortic aneurysm due to type IA endoleak. Given the proximity of the ruptured site to the superior mesenteric artery (SMA) and renal arteries, a ChEVAR was indicated. Catheterization of the target visceral vessels was a challenging procedural step because of an intensely tortuous thoracic aorta. This hostile aortic anatomy also inhibited exchange for a super stiff guide-wire and selective cannulation with the diagnostic catheter was repeatedly lost when guidewire exchange was attempted. To overcome this issue, a 5 x 40 mm balloon catheter was placed 3cm into the target arteries. The balloon was then inflated below the nominal pressure limit enabling safe exchange for a super stiff guidewire and placement of three 90-cm long 7Fr guiding sheaths. The procedure was thus safely performed with deployment of an aortic extension and the bridging stents..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
Jornal Vascular Brasileiro - 22(2023) |
| Sprache: |
Englisch ; Portugiesisch |
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| Beteiligte Personen: |
Francisco Leonardo Galastri [VerfasserIn] |
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| Links: |
doi.org [kostenfrei] |
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| Themen: |
Abdominal aortic aneurysm |
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| doi: |
10.1590/1677-5449.202300182 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
DOAJ091116856 |
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| 520 | |a Abstract A 100-year-old male patient was admitted with a ruptured abdominal aortic aneurysm due to type IA endoleak. Given the proximity of the ruptured site to the superior mesenteric artery (SMA) and renal arteries, a ChEVAR was indicated. Catheterization of the target visceral vessels was a challenging procedural step because of an intensely tortuous thoracic aorta. This hostile aortic anatomy also inhibited exchange for a super stiff guide-wire and selective cannulation with the diagnostic catheter was repeatedly lost when guidewire exchange was attempted. To overcome this issue, a 5 x 40 mm balloon catheter was placed 3cm into the target arteries. The balloon was then inflated below the nominal pressure limit enabling safe exchange for a super stiff guidewire and placement of three 90-cm long 7Fr guiding sheaths. The procedure was thus safely performed with deployment of an aortic extension and the bridging stents. | ||
| 650 | 4 | |a endoleak | |
| 650 | 4 | |a abdominal aortic aneurysm | |
| 650 | 4 | |a endovascular procedure | |
| 650 | 4 | |a aneurysm, ruptured | |
| 650 | 4 | |a aged, 80 and over | |
| 650 | 4 | |a case report | |
| 653 | 0 | |a Surgery | |
| 653 | 0 | |a Diseases of the circulatory (Cardiovascular) system | |
| 700 | 0 | |a Leonardo Guedes Moreira Valle |e verfasserin |4 aut | |
| 700 | 0 | |a Marcela Juliano Silva Cunha |e verfasserin |4 aut | |
| 700 | 0 | |a Bruno Pagnin Schmid |e verfasserin |4 aut | |
| 700 | 0 | |a Rodrigo Gobbo Garcia |e verfasserin |4 aut | |
| 700 | 0 | |a David Salomão Lewi |e verfasserin |4 aut | |
| 700 | 0 | |a Breno Boueri Affonso |e verfasserin |4 aut | |
| 700 | 0 | |a Felipe Nasser |e verfasserin |4 aut | |
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