STAGED TREATMENT OF COMPLEX THORACOABDOMINAL ANEURYMS FOLLOW TYPE B CHRONIC DISSECTION
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
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 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799129848909660160 |