HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK
Autor(a) principal: | |
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Data de Publicação: | 2021 |
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.337 |
Resumo: | Endovascular treatment of descending thoracic aortic aneurysms (DTAA) is associated with low rates of morbimortality and is currently the first line of therapeutic intervention. Endoleaks are a well-known complication of this technique, with the consensus that the identification of type I endoleak implies its prompt correction. We present the case of a patient who underwent TEVAR for the treatment of DTAA, with exclusion of the aneurysm in the control angiography. The control CTA showed type Ib endoleak with growth of the aneurysmal sac, so treatment was proposed which the patient refused. The patient was subsequently admitted urgently with rupture of the aneurysm and was immediately subjected to debranching of the visceral trunks, followed by distal TEVAR extension. The hybrid treatment of thoracic aneurysms without a distal landing zone through the debranching of the visceral trunks and TEVAR is an alternative to conventional surgery and complex endovascular surgery that presents good results in patients with high surgical risk and also allows to treat patients in an urgent regime since it does not depend on the manufacture of fenestrated and/or branched endoprostheses. |
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HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECKCIRURGIA HÍBRIDA NA ROTURA CONTIDA DE ANEURISMA TORÁCICO: UMA ALTERNATIVA EFICAZ NUM CASO SEM COLO DISTALDescending thoracic aortic aneurysmTEVARendoleakhybrid surgery, debranchingAneurisma da aorta torácica descendenteTEVARendoleakcirurgia hibrida, debranchingEndovascular treatment of descending thoracic aortic aneurysms (DTAA) is associated with low rates of morbimortality and is currently the first line of therapeutic intervention. Endoleaks are a well-known complication of this technique, with the consensus that the identification of type I endoleak implies its prompt correction. We present the case of a patient who underwent TEVAR for the treatment of DTAA, with exclusion of the aneurysm in the control angiography. The control CTA showed type Ib endoleak with growth of the aneurysmal sac, so treatment was proposed which the patient refused. The patient was subsequently admitted urgently with rupture of the aneurysm and was immediately subjected to debranching of the visceral trunks, followed by distal TEVAR extension. The hybrid treatment of thoracic aneurysms without a distal landing zone through the debranching of the visceral trunks and TEVAR is an alternative to conventional surgery and complex endovascular surgery that presents good results in patients with high surgical risk and also allows to treat patients in an urgent regime since it does not depend on the manufacture of fenestrated and/or branched endoprostheses.O tratamento endovascular dos aneurismas da aorta torácica descendente (AATD) está associado a baixas taxas de morbi- -mortalidade e é atualmente a primeira linha de intervenção terapêutica.. Os endoleaks são uma complicação bem conhecida desta técnica, sendo consensual que a identificação de endoleak tipo I implica a sua correção celere. Apresentamos o caso de uma doente submetida a TEVAR para tratamento de AATD, com exclusão do aneurisma no controlo angiográfico final. A angioTC de controlo mostrou endoleak tipo Ib com crescimento do saco aneurismático pelo que foi proposto tratamento, que a doente recusou. Admitida posteriormente de urgência, em rotura do aneurisma, a doente foi submetida de imediato a debranching dos troncos viscerais, seguido de extensão distal do TEVAR. O tratamento híbrido dos aneurismas torácicos sem landing zone distal através do debranching dos troncos viscerais e de TEVAR é uma alternativa à cirurgia convencional e à cirurgia endovascular complexa que apresenta bons resultados em doentes com risco cirúrgico elevado e permite ainda tratar doentes em regime urgente uma vez que não dependem da manufatura de endoprótese fenestradas e/ou ramificadas.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2021-03-05T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.337oai:ojs.acvjournal.com:article/337Angiologia e Cirurgia Vascular; Vol. 16 No. 4 (2020): December; 318-321Angiologia e Cirurgia Vascular; Vol. 16 N.º 4 (2020): Dezembro; 318-3212183-00961646-706Xreponame: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/337https://doi.org/10.48750/acv.337http://acvjournal.com/index.php/acv/article/view/337/222Copyright (c) 2021 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessPinto, VandaMinistro, AugustoHenriques, MickaelRodrigues, MartaMelo, RyanSilva, EmanuelPedro, Luís Mendes2022-05-23T15:10:10Zoai:ojs.acvjournal.com:article/337Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:41.701585Repositório 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 |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK CIRURGIA HÍBRIDA NA ROTURA CONTIDA DE ANEURISMA TORÁCICO: UMA ALTERNATIVA EFICAZ NUM CASO SEM COLO DISTAL |
title |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK |
spellingShingle |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK Pinto, Vanda Descending thoracic aortic aneurysm TEVAR endoleak hybrid surgery, debranching Aneurisma da aorta torácica descendente TEVAR endoleak cirurgia hibrida, debranching |
title_short |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK |
title_full |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK |
title_fullStr |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK |
title_full_unstemmed |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK |
title_sort |
HYBRID SURGERY ON THORACIC ANEURISM RUPTURE: AN EFFECTIVE ALTERNATIVE IN A CASE WITHOUT DISTAL NECK |
author |
Pinto, Vanda |
author_facet |
Pinto, Vanda Ministro, Augusto Henriques, Mickael Rodrigues, Marta Melo, Ryan Silva, Emanuel Pedro, Luís Mendes |
author_role |
author |
author2 |
Ministro, Augusto Henriques, Mickael Rodrigues, Marta Melo, Ryan Silva, Emanuel Pedro, Luís Mendes |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Pinto, Vanda Ministro, Augusto Henriques, Mickael Rodrigues, Marta Melo, Ryan Silva, Emanuel Pedro, Luís Mendes |
dc.subject.por.fl_str_mv |
Descending thoracic aortic aneurysm TEVAR endoleak hybrid surgery, debranching Aneurisma da aorta torácica descendente TEVAR endoleak cirurgia hibrida, debranching |
topic |
Descending thoracic aortic aneurysm TEVAR endoleak hybrid surgery, debranching Aneurisma da aorta torácica descendente TEVAR endoleak cirurgia hibrida, debranching |
description |
Endovascular treatment of descending thoracic aortic aneurysms (DTAA) is associated with low rates of morbimortality and is currently the first line of therapeutic intervention. Endoleaks are a well-known complication of this technique, with the consensus that the identification of type I endoleak implies its prompt correction. We present the case of a patient who underwent TEVAR for the treatment of DTAA, with exclusion of the aneurysm in the control angiography. The control CTA showed type Ib endoleak with growth of the aneurysmal sac, so treatment was proposed which the patient refused. The patient was subsequently admitted urgently with rupture of the aneurysm and was immediately subjected to debranching of the visceral trunks, followed by distal TEVAR extension. The hybrid treatment of thoracic aneurysms without a distal landing zone through the debranching of the visceral trunks and TEVAR is an alternative to conventional surgery and complex endovascular surgery that presents good results in patients with high surgical risk and also allows to treat patients in an urgent regime since it does not depend on the manufacture of fenestrated and/or branched endoprostheses. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-03-05T00:00:00Z |
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.337 oai:ojs.acvjournal.com:article/337 |
url |
https://doi.org/10.48750/acv.337 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/337 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/337 https://doi.org/10.48750/acv.337 http://acvjournal.com/index.php/acv/article/view/337/222 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 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. 16 No. 4 (2020): December; 318-321 Angiologia e Cirurgia Vascular; Vol. 16 N.º 4 (2020): Dezembro; 318-321 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 |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799129849847087104 |