Hybrid Repair of Concomitant Descending Thoracic and Abdominal Aortic Aneurysms Using Antegrade Visceral Debranching from the Ascending Aorta
- VernacularTitle:胸部下行・腹部大動脈瘤同時合併症例に対して上行大動脈からの腹部分枝バイパスおよびステントグラフト内挿術を施行した1例
- Author:
Minami IIO
1
;
Naoki FUJIMURA
1
;
Shuichiro YOSHITAKE
1
;
Satoshi OTSUBO
1
;
Takashi HIROTANI
1
Author Information
- Keywords: thoracoabdominal aortic aneurysm; hybrid repair; ascending aorta
- From:Japanese Journal of Cardiovascular Surgery 2019;48(2):128-133
- CountryJapan
- Language:Japanese
- Abstract: A 76-year-old man had increasing thoracic and abdominal aortic aneurysms. First, endovascular repair was performed on the thoracic descending aorta, but type Ib endoleak persisted due to severe aortic calcification. Additional treatment was planned since the maximum diameter of the thoracic and abdominal aortic aneurysms had increased to 75 and 70 mm, respectively. Due to the fact that aortic calcification was present from the aortic arch to the bilateral iliac arteries, which is sometimes referred to as porcelain aorta, conventional open thoracoabdominal aortic repair or hybrid repair using retrograde debranching seemed impossible. Therefore we performed antegrade visceral debranching from the ascending aorta followed by endovascular thoracoabdominal aortic repair successfully. For the thoracoabdominal aortic aneurysms which present difficulty in performing conventional open surgical repair or hybrid repair with retrograde debranching from the iliac artery. This technique can be an effective alternative strategy, but still needs further investigation, including its indications, due to the high surgical stress associated with the procedure.
