Arterial-bypass-supported endovascular thoracic aortic repair
- VernacularTitle:动脉旁路辅助下胸主动脉腔内修复的探讨
- Author:
Zhihui DONG
;
Weiguo FU
;
Yuqi WANG
- Publication Type:Journal Article
- Keywords:
Aneurysm;
Aorta, thoracic;
Endovascular repair
- From:
Chinese Journal of Interventional Cardiology
2003;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the feasibility and efficacy of endovascular thoracic aortic repair supported by preliminary arterial bypass. Methods From June 2003 to Jan. 2005, eight patients underwent endovascular repair (EVR) combined with supportive arterial reconstruction in the thoracic aorta. Five patients had Debakey type Ⅲ aortic dissection aneurysm (ADA), and the remaining 3 had descending thoracic aortic aneurysm (DTAA), aortic arch aneurysm and aortic arch pseudoaneurysm respectively. The proximal landing zone was measured less than 15 mm in all instances by contrast-enhanced CT scan and digital subtraction angiography. The preliminary right-left axillary bypass was performed in an ADA case in whom the distance from the primary entry site to the origin of the left common carotid artery was longer than 15mm,and the right- left carotid and left carotid-subclavian bypass in the remaining 7 cases. EVR was conducted 1 week after the bypass. Results All procedures were performed successfully. However, the DTAA patient died of the hemispheric cerebral infarction and subsequent multiple system organ failure, albeit the uneventful recovery from the prior cervical reconstruction. Type Ⅱ endoleak occurred at the completion of EVR in the patient receiving the axillary bypass, but disappeared on 3-month CT. No neurological deficits or limb ischemia developed perioperatively or during the follow-up raging from 3 to 22 months, and complete thrombosis of the thoracic aortic false lumen or of the aneurysm/pseudoaneurysm was revealed on CT at 3 months in the 7 patients. Conclusion The adjunctive surgical bypass appeared to be feasible and effective in creating extra proximal landing zone for endovascular thoracic aortic repair, and thus broaden its application.
