Staged Thoracic and Abdominal Aortic Aneurysm Repair Using Stent Graft Technology and Surgery in a Patient with Acute Renal Failure |
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Authors: | Darwin Eton Thomas T Terramani Michael Katz |
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Institution: | (1) Department of Surgery, Division of Vascular Surgery, University of Southern California, School of Medicine, Los Angeles, CA, US;(2) Department of Interventional Radiology, University of Southern California, School of Medicine, Los Angeles, CA, US |
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Abstract: | 2 ) angiography identified a saccular thoracic aortic aneurysm, right renal artery stenosis, left renal artery occlusion, an
infrarenal aortic aneurysm, celiac artery, and inferior mesenteric artery (IMA) orificial stenoses. Via an anterior retroperitoneal
approach, bilateral renal artery thromboendarterectomy, infrarenal aortic aneurysmectomy, and IMA reimplantation were performed.
The patient's tortuous iliac arteries were straightened to permit future passage of a thoracic stent graft by mobilizing the
aortic bifurcation and anastomosing it to a Dacron graft within 4 cm of the renal vessels. Two weeks later, a stent graft
was placed via a femoral incision utilizing CO2 angiography, successfully excluding the saccular thoracic aneurysm. Recovery from both procedures was quick, with rapid return
of renal function, and alleviation of the hypertension. At 8 months follow-up, his renal arteries and aorta are patent. |
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Keywords: | |
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