Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.496 |
Resumo: | INTRODUCTION: Endovascular reconstruction of the thoracoabdominal aorta is highly complex due to the need to preserve the main visceral branches. Optimal treatment with fenestrated and branched aneurysm aortic repair (F/B-EVAR) is usually not possible in urgent situations. Parallel grafting technique as an “off-the-shelf” solution have been described with good short and medium-term results. CASE REPORT: A 44-year-old male, born in Guinea Bissau, presents to the emergency department with epigastric pain radiating to the dorsum. The patient had a history of large vessel vasculitis secondary to Bechet’s disease (HLA B51 allele positivity) and previous thoracic aneurysm aortic repair (TEVAR) to treat a paraceliac aortic pseudoaneurysm. Computed tomography angiography (CTA) demonstrated a pseudoaneurysm with approximately 10 cm diameter at zone 6 immediately distal to the previous endoprosthesis. The pseudoaneurysm was excluded with a parallel grafting technique using a 31mm aortic endoprosthesis with a periscope graft for the right renal artery in a “sandwich-like” configuration and a chimney graft for the superior mesenteric artery (SMA). Postoperative CTA confirmed the exclusion of the pseudoaneurysm and permeable bridging stents. CONCLUSION: The pathology of the thoracoabdominal aorta is technically demanding, requiring experience and detailed planning. The complexity increases in emergency cases. Our case highlights that the parallel grafting technique should be encouraged in life-threatening scenarios as a readily available solution for complex aortic repair, even in a reconstructed aorta. |
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Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatmentBehçet’s diseasethoracic aneurysm, aorticendovascularoff-the-shelf treatmentsandwich techniquecovered stentINTRODUCTION: Endovascular reconstruction of the thoracoabdominal aorta is highly complex due to the need to preserve the main visceral branches. Optimal treatment with fenestrated and branched aneurysm aortic repair (F/B-EVAR) is usually not possible in urgent situations. Parallel grafting technique as an “off-the-shelf” solution have been described with good short and medium-term results. CASE REPORT: A 44-year-old male, born in Guinea Bissau, presents to the emergency department with epigastric pain radiating to the dorsum. The patient had a history of large vessel vasculitis secondary to Bechet’s disease (HLA B51 allele positivity) and previous thoracic aneurysm aortic repair (TEVAR) to treat a paraceliac aortic pseudoaneurysm. Computed tomography angiography (CTA) demonstrated a pseudoaneurysm with approximately 10 cm diameter at zone 6 immediately distal to the previous endoprosthesis. The pseudoaneurysm was excluded with a parallel grafting technique using a 31mm aortic endoprosthesis with a periscope graft for the right renal artery in a “sandwich-like” configuration and a chimney graft for the superior mesenteric artery (SMA). Postoperative CTA confirmed the exclusion of the pseudoaneurysm and permeable bridging stents. CONCLUSION: The pathology of the thoracoabdominal aorta is technically demanding, requiring experience and detailed planning. The complexity increases in emergency cases. Our case highlights that the parallel grafting technique should be encouraged in life-threatening scenarios as a readily available solution for complex aortic repair, even in a reconstructed aorta.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2023-08-15info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.496https://doi.org/10.48750/acv.496Angiologia e Cirurgia Vascular; Vol. 19 No. 2 (2023): June; 42-45Angiologia e Cirurgia Vascular; Vol. 19 N.º 2 (2023): Junho; 42-452183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/496http://acvjournal.com/index.php/acv/article/view/496/343Copyright (c) 2023 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessAzevedo Mendes, DanielMachado, RuiPereira, CarlosCastro, JoãoAlmeida, Rui2023-08-18T10:30:21Zoai:ojs.acvjournal.com:article/496Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:27:16.278990Repositório 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 |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
title |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
spellingShingle |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment Azevedo Mendes, Daniel Behçet’s disease thoracic aneurysm, aortic endovascular off-the-shelf treatment sandwich technique covered stent |
title_short |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
title_full |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
title_fullStr |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
title_full_unstemmed |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
title_sort |
Parallel grafting technique for a complex zone 6 aortic pseudoaneurysm treatment |
author |
Azevedo Mendes, Daniel |
author_facet |
Azevedo Mendes, Daniel Machado, Rui Pereira, Carlos Castro, João Almeida, Rui |
author_role |
author |
author2 |
Machado, Rui Pereira, Carlos Castro, João Almeida, Rui |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Azevedo Mendes, Daniel Machado, Rui Pereira, Carlos Castro, João Almeida, Rui |
dc.subject.por.fl_str_mv |
Behçet’s disease thoracic aneurysm, aortic endovascular off-the-shelf treatment sandwich technique covered stent |
topic |
Behçet’s disease thoracic aneurysm, aortic endovascular off-the-shelf treatment sandwich technique covered stent |
description |
INTRODUCTION: Endovascular reconstruction of the thoracoabdominal aorta is highly complex due to the need to preserve the main visceral branches. Optimal treatment with fenestrated and branched aneurysm aortic repair (F/B-EVAR) is usually not possible in urgent situations. Parallel grafting technique as an “off-the-shelf” solution have been described with good short and medium-term results. CASE REPORT: A 44-year-old male, born in Guinea Bissau, presents to the emergency department with epigastric pain radiating to the dorsum. The patient had a history of large vessel vasculitis secondary to Bechet’s disease (HLA B51 allele positivity) and previous thoracic aneurysm aortic repair (TEVAR) to treat a paraceliac aortic pseudoaneurysm. Computed tomography angiography (CTA) demonstrated a pseudoaneurysm with approximately 10 cm diameter at zone 6 immediately distal to the previous endoprosthesis. The pseudoaneurysm was excluded with a parallel grafting technique using a 31mm aortic endoprosthesis with a periscope graft for the right renal artery in a “sandwich-like” configuration and a chimney graft for the superior mesenteric artery (SMA). Postoperative CTA confirmed the exclusion of the pseudoaneurysm and permeable bridging stents. CONCLUSION: The pathology of the thoracoabdominal aorta is technically demanding, requiring experience and detailed planning. The complexity increases in emergency cases. Our case highlights that the parallel grafting technique should be encouraged in life-threatening scenarios as a readily available solution for complex aortic repair, even in a reconstructed aorta. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-08-15 |
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.496 https://doi.org/10.48750/acv.496 |
url |
https://doi.org/10.48750/acv.496 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/496 http://acvjournal.com/index.php/acv/article/view/496/343 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 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. 19 No. 2 (2023): June; 42-45 Angiologia e Cirurgia Vascular; Vol. 19 N.º 2 (2023): Junho; 42-45 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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1799133540973019136 |