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Floating Stent-Graft as a Support to Bridge an Unfavorable Renal Artery During Postdissection TAAA Repair Using a Multibranched Thoracoabdominal Endograft.
Rossi, Giulia; Perini, Paolo; Tecchio, Tiziano; Bianchini Massoni, Claudio; D'ospina, Rita; Freyrie, Antonio.
Afiliación
  • Rossi G; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Italy.
  • Perini P; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Italy.
  • Tecchio T; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Italy.
  • Bianchini Massoni C; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Italy.
  • D'ospina R; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Italy.
  • Freyrie A; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Italy.
J Endovasc Ther ; 27(6): 922-928, 2020 Dec.
Article en En | MEDLINE | ID: mdl-32729774
Purpose: To report an unusual endovascular technique to manage unfavorable renal artery anatomy encountered in an urgent case of symptomatic postdissection thoracoabdominal aortic aneurysm (TAAA) treated with an off-the-shelf multibranched device. Technique: The technique is demonstrated in a 77-year-old woman who had a history of previous open abdominal aortic aneurysm repair and an emergent procedure to implant a thoracic endograft and an aortic bare Z-stent (PETTICOAT) for acute Stanford type B dissection 7 years prior. The patient presented with a symptomatic, rapidly growing, postdissection TAAA. Endovascular treatment with a Zenith t-Branch was planned. After standard catheterization techniques failed in the left renal artery, a bailout maneuver was utilized to place a "floating" Viabahn stent-graft in the aneurysm sac to create sufficient support to deliver the bridging stent-grafts through the bare stent to the target left renal artery. The procedure was successful in excluding the TAAA and preserving perfusion to all target vessels. No neurological complications occurred. Six-month imaging follow-up confirmed the patency of the bridging stents. Conclusion: Remodeling changes after complex endovascular TAAA procedures often require the use of innovative techniques and materials during secondary procedures. In this case, the presence of a post-PETTICOAT bare aortic stent and hostile target artery anatomy increased the technical difficulty of t-Branch implantation. A "floating" stent-graft could be useful to reach challenging target vessels by providing additional support to bridging stent advancement and deployment.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Arteria Renal / Stents / Implantación de Prótesis Vascular / Procedimientos Endovasculares Límite: Aged / Female / Humans Idioma: En Revista: J Endovasc Ther Asunto de la revista: ANGIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Arteria Renal / Stents / Implantación de Prótesis Vascular / Procedimientos Endovasculares Límite: Aged / Female / Humans Idioma: En Revista: J Endovasc Ther Asunto de la revista: ANGIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Italia