STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION

Detalhes bibliográficos
Autor(a) principal: Catarino, Joana
Data de Publicação: 2019
Outros Autores: Alves, Gonçalo, Gonçalves, Frederico, Ferreira, Rita, Camacho, Nelson, Correia, Ricardo, Bento, Rita, Ferreira, Maria Emília
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.48750/acv.177
Resumo: Introduction: Most thoracoabdominal aneuryms (AATA) have a degenerative etiology, non the least, about 20% can be a consequence of chronic dissection, and from those, 40% will require surgical treatment regardless the initial optimal medical treatment. Clinical case: Male patient, 68 years old, with previous history of hypertension and smoker. Angio TC showed a chronic aortic dissection with a complex thoracoabdominal aneuryms and the patient was proposed to a surgical hybrid solution. The first surgery was a Frozen Elephant Trunk followed, days later, by a thoracic endograft to the celiac trunk with distal extension with a dissection stent. Then, a thoracooabdominal endograft (Zenith® t-Branch®). The post operative period was without complications and the follow-up CT showed the normal patency of all endografts and no endoleaks. Conclusion: Staged endovascular treatment of complex AATA looks promising specially when it comes to lower morbidity rates. However, these results can vary depending on patient selection and surgeon skills. Also important is the fact that long term outcomes of such therapy in these specific group of patients are not yet established so, cautious follow-up is needed.
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spelling STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTIONTRATAMENTO FASEADO DE ANEURISMA TORACOABDOMINAL COMPLEXO PÓS DISSECÇÃO AÓRTICA TIPO BComplex thoracoabdominal aneurymsChronic type B dissectionAneurisma toracoabdominal complexoDissecção aórtica crónica tipo BIntroduction: Most thoracoabdominal aneuryms (AATA) have a degenerative etiology, non the least, about 20% can be a consequence of chronic dissection, and from those, 40% will require surgical treatment regardless the initial optimal medical treatment. Clinical case: Male patient, 68 years old, with previous history of hypertension and smoker. Angio TC showed a chronic aortic dissection with a complex thoracoabdominal aneuryms and the patient was proposed to a surgical hybrid solution. The first surgery was a Frozen Elephant Trunk followed, days later, by a thoracic endograft to the celiac trunk with distal extension with a dissection stent. Then, a thoracooabdominal endograft (Zenith® t-Branch®). The post operative period was without complications and the follow-up CT showed the normal patency of all endografts and no endoleaks. Conclusion: Staged endovascular treatment of complex AATA looks promising specially when it comes to lower morbidity rates. However, these results can vary depending on patient selection and surgeon skills. Also important is the fact that long term outcomes of such therapy in these specific group of patients are not yet established so, cautious follow-up is needed.Introdução: Apesar dos aneurismas toracoabdominais (AATA) serem na sua maioria de etiologia degenerativa, cerca de 20% podem corresponder a sequela de dissecção crónica da aorta, dos quais a dilatação do falso lúmen necessita de tratamento cirúrgico em aproximadamente 40% dos doentes, independentemente do tratamento médico inicial. Caso clínico: Doente de 68 anos, sexo masculino, com antecedentes pessoais de HTA e tabagismo. Angio TC que revelou dissecção aórtica crónica, a condicionar dilatação aneurismática da aorta toracoabdominal. Foi proposta a realização de tratamento cirúrgico hibrido faseado. Em primeiro lugar foi realizado um Frozen Elephant Trunk, seguido de colocação de endoprótese torácica até à emergência do TC e, extensão distal com stent de dissecção. Posteriormente, foi colocada uma endoprótese toracoabdominal (Zenith® t-Branch®). O período pós-operatório decorreu sem intercorrências, sem complicações neurológicas, e o angio TC follow-up mostra patência de todas as endopróteses, sem presença de endoleaks. Conclusão: O tratamento faseado endovascular parece promissor no que diz respeito ao tratamento de AATA complexos, nomeadamente na diminuição da morbimortalidade associada. No entanto, estes resultados podem ser variáveis, depen- dendo da seleção dos doentes e da experiência do cirurgião, que assumem primordial importância. Também importante é o fato de não existirem ainda estudos a longo prazo realizados especificamente neste grupo de doentes e, como tal, o follow-up apertado assume particular relevância.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2019-12-27T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.177oai:ojs.acvjournal.com:article/177Angiologia e Cirurgia Vascular; Vol. 15 No. 3 (2019): September; 206-209Angiologia e Cirurgia Vascular; Vol. 15 N.º 3 (2019): Setembro; 206-2092183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://acvjournal.com/index.php/acv/article/view/177https://doi.org/10.48750/acv.177http://acvjournal.com/index.php/acv/article/view/177/152Copyright (c) 2019 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessCatarino, JoanaAlves, GonçaloGonçalves, FredericoFerreira, RitaCamacho, NelsonCorreia, RicardoBento, RitaFerreira, Maria Emília2022-05-23T15:10:04Zoai:ojs.acvjournal.com:article/177Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:33.885640Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
TRATAMENTO FASEADO DE ANEURISMA TORACOABDOMINAL COMPLEXO PÓS DISSECÇÃO AÓRTICA TIPO B
title STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
spellingShingle STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
Catarino, Joana
Complex thoracoabdominal aneuryms
Chronic type B dissection
Aneurisma toracoabdominal complexo
Dissecção aórtica crónica tipo B
title_short STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
title_full STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
title_fullStr STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
title_full_unstemmed STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
title_sort STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
author Catarino, Joana
author_facet Catarino, Joana
Alves, Gonçalo
Gonçalves, Frederico
Ferreira, Rita
Camacho, Nelson
Correia, Ricardo
Bento, Rita
Ferreira, Maria Emília
author_role author
author2 Alves, Gonçalo
Gonçalves, Frederico
Ferreira, Rita
Camacho, Nelson
Correia, Ricardo
Bento, Rita
Ferreira, Maria Emília
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Catarino, Joana
Alves, Gonçalo
Gonçalves, Frederico
Ferreira, Rita
Camacho, Nelson
Correia, Ricardo
Bento, Rita
Ferreira, Maria Emília
dc.subject.por.fl_str_mv Complex thoracoabdominal aneuryms
Chronic type B dissection
Aneurisma toracoabdominal complexo
Dissecção aórtica crónica tipo B
topic Complex thoracoabdominal aneuryms
Chronic type B dissection
Aneurisma toracoabdominal complexo
Dissecção aórtica crónica tipo B
description Introduction: Most thoracoabdominal aneuryms (AATA) have a degenerative etiology, non the least, about 20% can be a consequence of chronic dissection, and from those, 40% will require surgical treatment regardless the initial optimal medical treatment. Clinical case: Male patient, 68 years old, with previous history of hypertension and smoker. Angio TC showed a chronic aortic dissection with a complex thoracoabdominal aneuryms and the patient was proposed to a surgical hybrid solution. The first surgery was a Frozen Elephant Trunk followed, days later, by a thoracic endograft to the celiac trunk with distal extension with a dissection stent. Then, a thoracooabdominal endograft (Zenith® t-Branch®). The post operative period was without complications and the follow-up CT showed the normal patency of all endografts and no endoleaks. Conclusion: Staged endovascular treatment of complex AATA looks promising specially when it comes to lower morbidity rates. However, these results can vary depending on patient selection and surgeon skills. Also important is the fact that long term outcomes of such therapy in these specific group of patients are not yet established so, cautious follow-up is needed.
publishDate 2019
dc.date.none.fl_str_mv 2019-12-27T00:00:00Z
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dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://doi.org/10.48750/acv.177
oai:ojs.acvjournal.com:article/177
url https://doi.org/10.48750/acv.177
identifier_str_mv oai:ojs.acvjournal.com:article/177
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dc.relation.none.fl_str_mv http://acvjournal.com/index.php/acv/article/view/177
https://doi.org/10.48750/acv.177
http://acvjournal.com/index.php/acv/article/view/177/152
dc.rights.driver.fl_str_mv Copyright (c) 2019 Angiologia e Cirurgia Vascular
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2019 Angiologia e Cirurgia Vascular
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Angiologia e Cirurgia Vascular
publisher.none.fl_str_mv Sociedade Portuguesa de Angiologia e Cirurgia Vascular
dc.source.none.fl_str_mv Angiologia e Cirurgia Vascular; Vol. 15 No. 3 (2019): September; 206-209
Angiologia e Cirurgia Vascular; Vol. 15 N.º 3 (2019): Setembro; 206-209
2183-0096
1646-706X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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