Thoracic endovascular repair of descending thoracic aorta aneurysm using thoracic stent graft in a challenging complex patient : An innovative access technique during an emergency using a mini-thoracotomy approach
OBJECTIVES: Repairing thoracic aortic aneurysms with endovascular aortic repair (TEVAR) is a safe and minimally invasive method with low morbidity and short postoperative recovery. We developed a novel method to treat descending thoracic aortic aneurysms using a mini-thoracotomy approach in complex patients with difficult access.
METHODS: A 56-year-old male patient presented with a 3-day history of chest pain. His past surgical history included infrarenal aortic ligation and right axillobifemoral bypass. Thoracic computed tomography angiography (CTA) revealed a saccular aortic aneurysmal dilatation at zone 2 measuring 4.4 × 4 cm. Owing to his surgical history, vascular access through the femoral and iliac arteries or abdominal aorta was impossible. We developed a new technique using a left posterolateral mini-thoracotomy approach to gain vascular access and perform TEVAR, avoiding the need for an open thoracotomy repair.
RESULTS AND CONCLUSIONS: Thoracic CTA performed before discharge revealed complete aneurysmal exclusion and no endoleaks. Postoperative follow-up CTA (6 months and annually thereafter) revealed no aneurysm formation or aortic restenosis. The femoral artery, followed by the iliac artery, is the traditional access route for TEVAR. Left posterolateral mini-thoracotomy may be required as an alternative access in complex patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Vascular - (2024) vom: 07. März, Seite 17085381241238041 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Altoijry, Abdulmajeed [VerfasserIn] |
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| Links: |
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| Themen: |
Descending thoracic aorta aneurysm |
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| Anmerkungen: |
Date Revised 07.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1177/17085381241238041 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369422317 |
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| 100 | 1 | |a Altoijry, Abdulmajeed |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Thoracic endovascular repair of descending thoracic aorta aneurysm using thoracic stent graft in a challenging complex patient |b An innovative access technique during an emergency using a mini-thoracotomy approach |
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| 500 | |a Date Revised 07.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a OBJECTIVES: Repairing thoracic aortic aneurysms with endovascular aortic repair (TEVAR) is a safe and minimally invasive method with low morbidity and short postoperative recovery. We developed a novel method to treat descending thoracic aortic aneurysms using a mini-thoracotomy approach in complex patients with difficult access | ||
| 520 | |a METHODS: A 56-year-old male patient presented with a 3-day history of chest pain. His past surgical history included infrarenal aortic ligation and right axillobifemoral bypass. Thoracic computed tomography angiography (CTA) revealed a saccular aortic aneurysmal dilatation at zone 2 measuring 4.4 × 4 cm. Owing to his surgical history, vascular access through the femoral and iliac arteries or abdominal aorta was impossible. We developed a new technique using a left posterolateral mini-thoracotomy approach to gain vascular access and perform TEVAR, avoiding the need for an open thoracotomy repair | ||
| 520 | |a RESULTS AND CONCLUSIONS: Thoracic CTA performed before discharge revealed complete aneurysmal exclusion and no endoleaks. Postoperative follow-up CTA (6 months and annually thereafter) revealed no aneurysm formation or aortic restenosis. The femoral artery, followed by the iliac artery, is the traditional access route for TEVAR. Left posterolateral mini-thoracotomy may be required as an alternative access in complex patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Descending thoracic aorta aneurysm | |
| 650 | 4 | |a mini-thoracotomy | |
| 650 | 4 | |a thoracic endovascular aortic repair | |
| 650 | 4 | |a vascular access | |
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