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1.
Urgent thoracic aortal dissection and aneurysm: treatment with stent-graft implantation in an angiographic suite 总被引:2,自引:0,他引:2
The aim of this study was to evaluate the feasibility of endoluminal stent-graft placement in an angiographic suite for the
treatment of emergent type-B aortic dissections and ruptured thoracic aortal aneurysms. Twenty-six patients with either urgent
type-B dissection (n=8) or aneurysms (n=18) of the descending thoracic aorta were chosen for stent-graft implantation. All patients received a multidetector-row
CT angiography of the whole aorta and pelvic arteries prior to stent-graft implantation. All procedures were performed in
a fully equipped digital subtraction angiography (DSA) suite under general anesthesia. In 20 patients Talent LPS tube grafts
and in 4 patients an Excluder graft were used. Access was achieved via surgical cut-down in the left (n=7) or right (n=19) groin. Sealing was successful in 24 patients. The proximal covered portion of the stent graft was placed across the left
subclavian artery in 2 patients. Procedural success was achieved in 23 of 24 patients. One patient required a second stent-graft
placement before the aneurysm was sealed. One patient with an acute perforation of the descending aorta died due to cardiac
failure prior to stent-graft implantation. In 1 patient stent-graft delivery failed due to severe calcification of both common
iliac arteries. Endoluminal treatment of both urgent type-B aortic dissections and thoracic aortal aneurysms with stent graft
is an attractive alternative treatment to surgical repair. The placement of stent grafts in an angiographic suite is a safe
and feasible method with good clinical effectiveness and, so far, good clinical outcome. 相似文献
2.
Nørgaard A Andersen LI Haahr PE Justesen P 《Acta radiologica (Stockholm, Sweden : 1987)》2008,49(5):510-512
Surgical treatment of diseases of the thoracic aorta (aneurysms, dissections, and ruptures) may be associated with serious postoperative complications. Endovascular repair of thoracic aorta pathology is less invasive and offers a therapeutic alternative in high-surgical-risk patients, particularly in the presence of previous surgical repair of the thoracic aorta. The endovascular procedure, however, is almost only possible in the descending thoracic aorta, although advances have also been made in the aortic arch as well as in the ascending aorta with branched stent grafts. We report a case of a surgically treated aneurysm in the ascending thoracic aorta complicated with an anastomotic leak. If a short prosthesis (6 cm) had been available, the anastomotic leak would have been treated with endovascular repair. In lack of this prosthesis, we were forced to treat the patient with a method not generally accepted--embolization with endovascular coils--successfully resulting in occlusion of the leakage. 相似文献
3.
T Sakai M D Dake C P Semba T Yamada A Arakawa S T Kee N Hayashi M K Razavi D Y Sze 《Radiology》1999,212(1):169-174
PURPOSE: To evaluate the usefulness of thoracic computed tomography (CT) after placement of an endovascular stent-graft for the treatment of descending thoracic aortic aneurysm. MATERIALS AND METHODS: From 1992 to 1996, 85 patients with thoracic aortic aneurysm underwent stent-graft placement. In 63 patients, thoracic CT scans were obtained both before and within 10 days after placement. The CT findings were retrospectively studied, and their clinical effect analyzed. In 20 of 63 patients, long-term follow-up CT findings were also evaluated. RESULTS: After stent-graft placement in the 63 patients, CT demonstrated an increase in pleural effusion in 46 (73%), periaortic changes in 21 (33%), perigraft leak in 13 (21%), atelectasis in six (10%), mural thrombus within the stent-graft in two (3%), and new aortic dissection in one (2%). The mean maximum diameter of the aneurysm was 58.8 mm before and 60.0 mm after stent-graft insertion. Sixty-two (98%) patients were successfully treated until discharge. Interventional procedures were performed to eliminate the leakage into the aneurysm sac in 10 patients with perigraft flow depicted at CT. Other complications were managed conservatively. CONCLUSION: Thoracic CT is useful in the treatment of patients after stent-graft insertion for the management of descending thoracic aortic aneurysm. 相似文献
4.
Engelke C Sandhu C Morgan RA Belli AM 《Journal of vascular and interventional radiology : JVIR》2002,13(6):625-629
An 80-year-old woman with established giant cell arteritis presented at the authors' institution with a 6.5-cm false aneurysm of the descending thoracic aorta complicated by focal dissection and intramural hematoma after a 1-week history of acute-onset chest pain. The patient underwent uncomplicated endovascular aortic repair with a 32-mm x 15-cm TagExcluder stent-graft. After the procedure, the intramural hematoma resolved and the patient's corticosteroid and immunosuppressive therapy was repeatedly adjusted. However, the giant cell arteritis activity relapsed after 8 months with development of a similar 1.5-cm false aneurysm below the thoracic stent-graft, complicated by focal intramural hematoma. Repeat uncomplicated thoracic stent-graft implantation was performed and CT follow-up displayed resorption of the intramural hematomas with no evidence of endoleak or any new aortic pathology. This report discusses the difficult management of patients with relapsing active aortic giant cell arteritis and the potential role for endovascular thoracic aortic repair. 相似文献
5.
Placement of endovascular stent-grafts for emergency treatment of acute disease of the descending thoracic aorta 总被引:7,自引:0,他引:7
Czermak BV Waldenberger P Perkmann R Rieger M Steingruber IE Mallouhi A Fraedrich G Jaschke WR 《AJR. American journal of roentgenology》2002,179(2):337-345
OBJECTIVE: The aim of this study was to evaluate the feasibility, safety, and effectiveness of endovascular stent-graft placement for the emergency treatment of acute descending thoracic aortic disease. MATERIALS AND METHODS: From January 1996 through November 2001, 18 patients underwent emergency endovascular stent-graft placement for various types of acute descending thoracic aortic disease. Five patients had Stanford type B aortic dissection, six had traumatic ruptures of the thoracic aorta, five had ruptured aortic aneurysms, and two had penetrating atherosclerotic aortic ulcers. All patients presented with life-threatening symptoms requiring treatment with stent-grafts from the emergency kit. All were at high surgical risk due to serious comorbidities. The efficacy of the procedure was assessed at follow-up studies before discharge and at 3, 6, and 12 months after intervention and yearly thereafter. RESULTS: The primary technical success rate was 78%. Four patients had primary perigraft leaks. The secondary technical success rate was 83%. One patient died 20 hr after intervention from stent-graft-related causes. Follow-up studies revealed stent-graft migration in one patient. Progression of disease was observed in one patient treated for dissection and in both patients treated for penetrating ulcers. One patient died 7 months after intervention of unknown reasons; all other patients are alive. The mean follow-up time was 17.4 months (range, 0-38 months). CONCLUSION: Emergency repair of acute descending thoracic aortic disease with stent-graft placement can be successfully accomplished and may be a promising alternative to open-chest surgery, especially in patients at high risk. 相似文献
6.
Rakesh P. Patel Athanasios Katsargyris Eric L. G. Verhoeven Donald J. Adam John A. Hardman 《Cardiovascular and interventional radiology》2013,36(6):1443-1451
The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR. 相似文献
7.
Interventional techniques in the treatment of aortic dissection 总被引:5,自引:0,他引:5
Sbarzaglia P Lovato L Buttazzi K Russo V Renzulli M La Palombara C Fattori R 《La Radiologia medica》2006,111(4):585-596
Acute aortic dissection continues to be one of the most catastrophic cardiovascular events. While there is a general consensus on immediate surgical repair when the ascending aorta is involved, the optimal treatment strategy for type B aortic dissection (B-AD) remains controversial. Recently, endovascular treatment with percutaneous stent-graft implantation, originally used for aortic aneurysm exclusion, has acquired an important role in the treatment of B-AD. Imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and angiography have a fundamental role in the search for the anatomic details necessary to tailor the stent graft and in evaluating the most suitable anatomy for stent graft. Transesophageal echocardiography is fundamental during the procedure to monitor the correct release of the stent graft and evaluate the result of the procedure expressed by immediate thrombosis out of the stent-graft. Again, imaging techniques, more notably CT, have a fundamental role in the postoperative followup after stent-graft placement. The risk of endoleaks may compromise the result of endovascular repair and increase the risk of aortic rupture. Several reports and a few trials attesting to technical feasibility and safety of stent-graft implantation procedures for B-AD have been reported so far. Also, a randomised trial comparing type B aortic stent-graft placement with medical therapy is currently underway. According to the investigators, new therapeutic indications are likely to emerge also in uncomplicated B-AD. 相似文献
8.
目的评估覆膜支架治疗术治疗Stanford B型主动脉夹层和降主动脉瘤的安全性和近期疗效。方法2003年3月至2005年9月期间,共29例Stanford B型主动脉夹层和2例降胸主动脉瘤患者接受覆膜支架治疗术,所有患者均有高血压病史,其中急性发病27例.本组采用两种支架(Mdtronic Talent15例,上海微创Aegis 16例),术后采用CTA进行定期随访。结果所有支架均成功按预期定位释放,术后即刻DSA复查显示23例夹层患者近端破裂口完全封闭,2例降主动脉瘤也完全隔离,6例发现有内漏;术后7 d CTA复查发现16例假腔内完全血栓形成,12例近端假腔形成血栓,远端假腔仍开放。结论覆膜支架术治疗Stanford B型主动脉夹层和降主动脉瘤安全、有效,可替代外科手术。但覆膜支架术的确切长期疗效尚待进一步的大样本、前瞻性对照研究才能确定。 相似文献
9.
Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent-grafts 总被引:16,自引:0,他引:16
Won JY Lee DY Shim WH Chang BC Park SI Yoon CS Kwon HM Park BH Jung GS 《Journal of vascular and interventional radiology : JVIR》2001,12(5):575-582
PURPOSE: To report our experience of endovascular stent-graft placement in patients with descending thoracic aortic dissections and aneurysms and to evaluate the feasibility, safety, and clinical outcomes of the treatment. MATERIALS AND METHODS: Stent-grafts were placed in the descending thoracic aortas of 23 patients with saccular aneurysms (n = 11) and Stanford type B chronic aortic dissections of the descending thoracic and abdominal aorta (n = 12). All stent-grafts were individually constructed of self-expandable stainless steel stents covered with polytetrafluoroethylene. Vascular access was achieved through the femoral artery in all patients. Clinical status of each patient was monitored and postoperative CT was performed within 1 month of the procedure and at 3-12-month intervals after the procedures. RESULTS: Successful exclusion of the primary entry tears of dissections and the inlets of saccular aneurysms was achieved in all but two patients with aortic dissection. The overall technical success rate was 91.3% (dissection: 10 of 12 = 83%; aneurysm: 11 of 11 = 100%). All patients in whom technical success was achieved showed complete thrombosis and significant decrease in diameter of the thoracic false lumen (preoperative: 5.3 cm +/- 0.9; postoperative: 4.3 cm +/- 0.9; P = .004) or aneurysm sac (preoperative: 5.3 cm +/- 1.7; postoperative: 2.8 cm +/- 2.5; P = .001). In addition, five patients demonstrated complete resolution of the dissected thoracic false lumen (n = 2) and aneurysm sac (n = 3). However, in all patients with aortic dissection, the abdominal aorta was not significantly changed in size (P = .302) and shape and their false lumen flows remained persistent. Immediate postoperative complications were detected in 12 patients (52%); 10 had fever, leukocytosis, and elevation of C-reactive protein, another had wound infection, and another had transient abdominal pain. Three patients died 2, 3, and 12 months after the procedure: one from septic shock, another from underlying mediastinitis, and the other from an unexplained cause. The remaining 20 patients were well after the procedure (1-9 days; mean, 3 days), without any stent-graft-related complications or discomfort (follow up period: 10-65 mo; mean: 25.1 mo +/- 15.6). The cumulative survival rate after the stent graft was 100% at 30 days and 91% at 12 months. CONCLUSIONS: For treatment of aortic dissection and saccular aneurysm of the descending thoracic aorta, endovascular stent-graft repair may be a technically feasible and effective treatment modality. 相似文献
10.
Taylor JD Dunckley M Thompson M Morgan RA 《Cardiovascular and interventional radiology》2008,31(Z2):S67-S71
Over the last 10 years endovascular stent-graft placement has been increasingly used to treat complicated acute Type B thoracic aortic dissections. While studies have demonstrated the use of additional aortic stent-grafts to treat continued false lumen perfusion and case reports have detailed the use of renal artery stents to treat renal ischemia related to aortic dissection, to our knowledge the adjuvant use of renal artery stents to reduce false lumen perfusion has not been reported. We present the case of a 72-year-old male who had previously undergone endovascular repair of a complicated Type B thoracic aortic dissection and presented with an expanding false lumen in the peridiaphragmatic aorta despite coverage of the entire thoracic aorta. This was treated by closure of a right renal fenestration using a renal stent. 相似文献
11.
Fattori R Napoli G Favalli M Lovato L Grazia C Fusco F Gavelli G 《La Radiologia medica》2001,101(6):488-494
PURPOSE: The endovascular treatment of the thoracic aorta is an effective alternative to open surgical repair and offers a therapeutic option even to patients at high risk for surgery. Our experience in the treatment of different diseases of descending thoracic aorta is reported. MATERIAL AND METHODS: Between July 1997 and January 2001, 50 patients were selected for endovascular treatment: 36/50 patients presented high risk for conventional surgery. Six patients presented clinical and imaging features suggesting impending rupture and were treated on emergency basis. The stent-graft prosthesis was individually manufactured or selected on the basis of spiral CT or MRI measurements. RESULTS: Endovascular stent positioning and deployment was technically successful in 49 cases. In one patient the tortuosity of the aortic arch prevented graft deployment. Complete aneurysm exclusion was achieved in 48 cases as assessed by post-procedure angiography and TEE. One proximal endoleak was noted and surgical conversion was performed 40 days later. There were no intraoperative mortality or complications. One patient presented extension of dissection at the 8th postoperative day and required of surgical repair. CT scan showed an endoleak in 4 cases that sealed spontaneously in three cases while the fourth case was treated by graft extension. In the long term two secondary endoleak were observed (12 and 24 months after the procedure). CONCLUSIONS: Endovascular stent-graft repair provides a less invasive opportunity to patients affected by thoracic aortic disease. Careful cases selection is the first postulate for the efficacy and safety of the procedure. 相似文献
12.
Descending thoracic aortic diseases: stent-graft repair 总被引:24,自引:0,他引:24
Fattori R Napoli G Lovato L Grazia C Piva T Rocchi G Angeli E Di Bartolomeo R Gavelli G 《Radiology》2003,229(1):176-183
PURPOSE: To evaluate endovascular treatment of descending thoracic aorta with commercially available self-expanding stent-grafts. MATERIALS AND METHODS: Seventy patients with aortic dissection, intramural hemorrhage, degenerative and posttraumatic aneurysm, penetrating atherosclerotic ulcer, and pseudoaneurysm underwent endovascular treatment. Eleven patients had impending rupture and were treated on an emergency basis. Stent-grafts were customized or selected on the basis of spiral computed tomographic (CT) or magnetic resonance (MR) imaging measurements. Preprocedure diagnostic angiography was performed in patients with aortic dissection and in other selected patients. All procedures were performed in an operating room and monitored with digital subtraction angiography (DSA) and transesophageal echocardiography (TEE). Follow-up was at 1, 3, 6, and 12 months after treatment and yearly thereafter. RESULTS: Stent positioning was technically successful in 68 cases. At DSA and TEE, complete aneurysm or false-lumen exclusion was achieved in 66 (97%) cases. No intraoperative mortality or complications occurred. In-hospital complications included transient monoparesis (one patient) and extension of dissection into ascending aorta (one patient) that was repaired surgically. Early endoleak was observed in five (7%) patients: In three (type 2), endoleak resolved spontaneously; in one (type 1), it was persistent; and in one (type 1), treatment was converted to surgery. At long term, one (1%) patient died of aortic rupture; another, of respiratory insufficiency. Five (7%) late endoleak (type 1, one caused by migration of the stent) cases were observed. In three (4%), endovascular treatment was successful; in two (3%), surgery was performed. In one patient with persistent postimplantation syndrome, treatment was converted to surgery after successful aneurysm sealing. Procedure failure (ie, aortic disease-related mortality or conversion to surgery) occurred in six (9%) patients. CONCLUSION: Endovascular stent-graft repair is less invasive in patients with chronic and acute descending thoracic aortic aneurysm and dissection. 相似文献
13.
Endovascular stent-graft management of thoracic aortic diseases. 总被引:8,自引:0,他引:8
M D Dake 《European journal of radiology》2001,39(1):42-49
The traditional standard therapy for descending thoracic aortic aneurysm (TAA) is open operative repair with graft replacement of the diseased aortic segment. Despite important advances in surgical techniques, anesthetic management, and post-operative care over the last 30 years, the mortality and morbidity of surgery remains considerable, especially in patients at high risk for thoracotomy because of coexisting severe cardiopulmonary abnormalities or other medical diseases. The advent of endovascular stent-graft technology provides an alternative to open surgery for selected patients with TAA. The initial experience suggests that stent-graft therapy potentially may reduce the operative risk, hospital stay and procedural expenses of TAA repair. These potential benefits are especially attractive for patients at high risk for open TAA repair. Current results of endovascular TAA therapy document operative mortalities of between 0 and 4%, aneurysm thrombosis in 90 and 100% of cases, and paraplegia as a complication in 0 and 1.6% of patients. The early success of stent-graft repair of TAA has fostered the application of these devices for the management of a wide variety of thoracic aortic pathologies, including acute and chronic dissection, intramural hematoma, penetrating ulcer, traumatic injuries, and other diseases. The results of prospective controlled trials that compare the outcomes of stent-graft therapy with those of surgical treatment in patients with specific types of aortic disease are anxiously awaited before recommendations regarding the general use of these new devices can be made with confidence. 相似文献
14.
Matsagas MI Anagnostopoulos CE Papakostas JC DeRose JJ Siminelakis S Katsouras CS Toumpoulis IK Drossos GE Michalis LK 《Cardiovascular and interventional radiology》2006,29(4):655-658
Thoracic and abdominal aortic endovascular procedures as alternatives to aortic reoperations were studied in three different
cases. An anastomotic aneurysm after previous thoracic aortic graft for coarctation, a second-stage elephant trunk repair
(descending thoracic aortic aneurysm), and a secondary aneurysm proximal to a previous abdominal aortic graft were successfully
treated with endovascular stent-grafts. During the follow-up period no lethal events or major aortic or graft-related complications
were observed, except a type II endoleak in the anastomotic aortic aneurysm case. An endovascular stent-graft can be safely
deployed into a previously implanted vascular graft, avoiding repeat surgery. 相似文献
15.
Fattori R Russo V Lovato L Buttazzi K Rinaldi G 《Cardiovascular and interventional radiology》2011,34(6):1137-1142
The overall survival of patients with thoracic aortic aneurysm (TAA) has improved significantly in the past few years. Endovascular
treatment, proposed as an alternative to surgery, has been considered a therapeutic innovation because of its low degree of
invasiveness, which allows the treatment of even high-surgical risk patients with limited complications and mortality. A major
limitation is the lack of adequate evidence regarding long-term benefit and durability because follow-up has been limited
to just a few years even in the largest series. The combination of endovascular exclusion with visceral branch revascularization
for the treatment of thoraco-abdominal aortic aneurysms involving the visceral aorta has also been attempted. As an alternative,
endografts with branches represent a technological evolution that allows treatment of complex anatomy. Even if only small
numbers of patients and short follow-up are available, this technical approach, which has with limited mortality (<10%) and
paraplegia rates, to expand endovascular treatment to TAA seems feasible. With improved capability to recognize proper anatomy
and select clinical candidates, the choice of endovascular stent-graft placement may offer a strategy to optimize management
and improve prognosis. 相似文献
16.
Endovascular treatment of late in-stent-graft dissection after thoracic endovascular aneurysm repair
Vulev I Klepanec A Balázs T Holomáň M 《Cardiovascular and interventional radiology》2011,34(4):864-867
Complications after endovascular repair of thoracic aortic pathologies may be devastating. We report the case of endovascular
treatment of late in–stent-graft dissection after thoracic endovascular aneurysm repair (TEVAR). A 25-year-old man was admitted
to our hospital 2 years after endovascular treatment of posttraumatic aortic pseudoaneurysm using stent-graft implantation
with an acute sudden onset of ischemia in both legs with absent femoral pulses, numbness, and renal functions deterioration.
Multidetector computed tomography (MDCT) angiography showed an intimal flap in the distal part of the stent-graft with critical
stenosis of the residual lumen. The patient was successfully treated with stent-graft implantation by way of percutaneous
approach while under local anesthesia. The risk of this late complication after TEVAR should be considered during follow-up,
especially in young patients with increased physical activity. Endovascular treatment can be the method of choice for these
patients. 相似文献
17.
Endovascular treatment of aortic type B dissection and penetrating ulcer using commercially available stent-grafts. 总被引:2,自引:0,他引:2
J Sailer P Peloschek T Rand M Grabenw?ger S Thurnher J Lammer 《AJR. American journal of roentgenology》2001,177(6):1365-1369
OBJECTIVE: The purpose of our study was to investigate the clinical experience and efficiency of translumenl endovascular stent-graft insertion using commercially available vascular endoprotheses. We studied seven patients with descending aortic dissection (type B) and four patients with penetrating aortic ulcer over a median follow-up period of 254 days during the years 1997-2000, using cross-sectional CT to evaluate the extent of the dissection, the distance between the entry tear and the left subclavian artery, and the diameter of the true lumen and the false lumen. CONCLUSION: Endovascular treatment of acute and chronic aortic type B dissections and penetrating ulcer is a minimally invasive method with a low complication rate that could be considered a feasible alternative to surgical repair. Depending on the length of the dissection, we recommend the placement of two overlapping stent-grafts in the thoracic aorta to stabilize the affected thoracic aorta over a longer distance. This might provide a reliable sealing of the entry tear and should prevent further communication between the true lumen and the false lumen. 相似文献
18.
Ricci C Ceccherini C Leonini S Cini M Vigni F Neri E Tucci E Benvenuti A Tommasino G Sassi C 《Cardiovascular and interventional radiology》2012,35(1):176-179
An innovative approach, the JAG tearing technique, was performed during thoracic endovascular aneurysm repair in a patient
with previous surgical replacement of the ascending aorta with a residual uncomplicated type B aortic dissection who developed
an aneurysm of the descending thoracic aorta with its lumen divided in two parts by an intimal flap. The proximal landing
zone was suitable to place a thoracic stent graft. The distal landing zone was created by cutting the intimal flap in the
distal third of the descending thoracic aorta with a radiofrequency guide wire and intravascular ultrasound catheter. 相似文献
19.
Penetrating atherosclerotic ulcer of the descending thoracic aorta: Treatment by endovascular stent-Graft 总被引:3,自引:0,他引:3
Salvatore Murgo M.D. Luc Dussaussois Jafar Golzarian Jean Christophe Cavenaile Hicham Tarik Abada José Ferreira Julien Struyven 《Cardiovascular and interventional radiology》1998,21(6):454-458
Purpose: To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal
stent-graft.
Methods: Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde
dissection. All patients were treated by endovascular stent-graft and were followed by helical computed tomography (CT).
Results: Endovascular stent-graft deployment was successful in all patients. However, in one case we observed a perigraft leak that
spontaneously disappeared within the first month, and two interventions were needed for another patient. Following treatment,
one episode of transient spinal ischemia was observed. The 30-day survival rate was 100%, but one patient died from pneumonia
with cardiac failure 34 days after the procedure. In one patient, helical CT performed at 3 months showed a false aneurysm
independent of the first ulcer. This patient refused any further treatment and suddenly died at home (unknown cause) after
a 6-month follow-up period.
Conclusion: Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta
appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible
complications of the disease. 相似文献
20.
Medda M Lioupis C Mollichelli N Fantoni C Inglese L 《Cardiovascular and interventional radiology》2008,31(2):386-390
We report the case of a patient with subtotal occlusion of the origin of the left common carotid artery (CCA) following thoracic
graft placement. Retrograde endovascular placement of a stent-graft by minimal cervical access was undertaken to repair the
occlusive lesion of the left CCA and prevent future complications of endoluminal thoracic reconstruction. The retrograde endovascular
repair of CCA lesions, as other authors have already suggested, may be the treatment of choice in “high-surgical-risk” patients.
In these cases where the ostium of supra-aortic trunks is compromised following thoracic aorta stent-graft migration, endoluminal
placement of a stent-graft in the CCA can guarantee both maintenance of carotid flow and thoracic stent-graft fixation. 相似文献