Parallel Graft to Preserve a Reimplanted Inferior Mesenteric Artery During Thoracoabdominal Multibranched Endografting.
Ann Vasc Surg
; 80: 394.e1-394.e6, 2022 Mar.
Article
em En
| MEDLINE
| ID: mdl-34775018
ABSTRACT
INTRODUCTION:
Preserving pelvic circulation is crucial to minimize the risk of spinal cord and colonic ischemia, especially during the endovascular treatment of extended thoraco-abdominal aneurysm (TAAA) after previous open repair (OR). CASE REPORT A 78-years-old patient, previously treated for AAA with OR and reimplantation of inferior mesenteric artery (IMA), has presented with 9 cm type-III TAAA and underwent to a multi-stage endovascular procedure. Two thoracic endografts, t-Branch and a straight endograft by Cook Zenith platform were deployed. Renal and superior mesenteric arteries were cannulated and revascularized. Through the left axillary access, a 5F-vertebral catheter was delivered over a 0.035 inch guidewire to selectively catheterize IMA. A post-anastomotic stenosis was stented to advance the sheath and the parallel-graft (Viabahn 7 × 150 mm, Gore) into the artery. Thus, a bifurcated endograft was deployed inside the previous OR. According to the Sandwich-Technique, the stentgraft was deployed parallel and outside the bifurcated device, inside the straight one and 2 cm into the IMA and then reinforced by a bare-metal-stent (Protégé EverFlex™ 7 × 120 mm, Medtronic). Finally, a kissing ballooning of iliac endografts and parallel-graft was performed. The procedure was completed five days later, by stenting the celiac trunk. Post-operative course was uneventful. The 36-months CTA showed the patency of the IMA with no complications.CONCLUSION:
The combination of t-Branch and Sandwich-Technique for IMA could be employed to treat extended TAAA with previous OR and reimplanted IMA thus minimizing the risk of colonic and spinal cord ischemia.
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Base de dados:
MEDLINE
Assunto principal:
Stents
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Artéria Mesentérica Inferior
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Aneurisma da Aorta Torácica
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Aneurisma da Aorta Abdominal
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Constrição Patológica
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Procedimentos Endovasculares
Limite:
Aged
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Humans
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Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article