Endovascular exclusion of a thoracoabdominal aortic aneurysm after retrograde visceral artery revascularization |
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Authors: | Gregoric Igor D Gupta Kamal Jacobs Michael J Poglajen Gregor Suvorov Nina Dougherty Kathy G Krajcer Zvonimir |
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Institution: | The Department of Cardiovascular Surgery, the Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA. knowlin@heart.thi.tmc.edu |
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Abstract: | Historically, open surgical repair of thoracoabdominal aortic aneurysms has been associated with high morbidity and mortality rates. Furthermore, endovascular exclusion alone can restrict blood flow to visceral arteries. We report a case of thoracoabdominal aortic aneurysm that was repaired using a hybrid approach: surgery followed by an endovascular procedure. A 53-year-old woman was admitted to our hospital for endovascular exclusion of a thoracoabdominal aortic aneurysm that included the superior mesenteric artery and the celiac artery. Aorto-mesenteric and aorto-celiac artery bypass grafting was performed to create a landing zone for subsequent endovascular exclusion of the aneurysm, which was completed successfully 6 weeks after the bypass procedure. For thoracoabdominal aortic aneurysms that extend beyond the superior mesenteric artery and the celiac or renal arteries, a hybrid approach, consisting of limited surgical treatment followed by endovascular exclusion of the aneurysm, may yield optimal results in selected patients with serious preoperative comorbidities. |
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