Successful Endovascular Stent-graft Treatment of a Ruptured Thoracoabdominal Aortic Aneurysm with Coverage of the Celiac Axis
10.4326/jjcvs.39.69
- VernacularTitle:破裂性胸腹部大動脈瘤に対し celiac axis を閉鎖して landing zone を確保したステントグラフト単独治療の1例
- Author:
Tsuyoshi Hachimaru
;
Masazumi Watanabe
;
Satoru Kawaguchi
;
Hideki Nakahara
- Publication Type:Journal Article
- Keywords:
ruptured thoracoabdominal aortic aneurysm;
stent-graft;
landing zone;
celiac axis;
collateral circulation
- From:Japanese Journal of Cardiovascular Surgery
2010;39(2):69-73
- CountryJapan
- Language:Japanese
-
Abstract:
A 73-year-old woman was referred to our hospital for treatment of a ruptured thoracoabdominal aortic aneurysm (TAAA). Computed tomography (CT) showed a ruptured saccular TAAA (maximum diameter, 70 mm) located just above the celiac trunk. The patient chose to undergo endovascular repair because of the high risk associated with conventional repair, so an emergency endovascular stent-graft treatment was performed. The collateral pathway from the superior mesenteric artery (SMA) to the celiac branches via the pancreaticoduodenal arcades was confirmed by selective angiography of the SMA before stent-grafting. The stent-graft was successfully deployed just proximal to the origin of the SMA with intentional coverage of the celiac axis to achieve sealing. Postoperatively, the patient was free from abdominal organ disorder or paraplegia/paraparesis and was discharged from the hospital after 36 days procedure. Follow-up CT scans performed at 1 week, month and 6 months showed patency in the SMA and the celiac branches, and there was no evidence of an endoleak. A less invasive endovascular repair procedure such as this can be an alternative treatment of a ruptured TAAA.
