DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS
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.352 |
Resumo: | Introduction: In chronic aortic dissection complicated with aneurysmal degeneration, there are commonly spontaneous tears between true and false lumen at the level of visceral arteries. However, in its absence or difficult identification, treatment with f/bEVAR is limited. In these, it may be required a fenestration procedure to allow visceral vessels access. Methods / Results: We present two case-reports of patients that underwent dissection flap fenestration procedures followed by f/bEVAR. In both patients, one-year follow-up CT scans show endoprosthesis and visceral branches patency, reduction of aneurysmal sac and absence of dissection or endoleaks. Conclusions: In fenestration creation, chronic dissection flap rigidity may require coarse devices with increased risk of aortic rupture, as TIPS needle. To prevent this complication, besides meticulous preoperative planning by CT angiography, intraoperative identification of true and false lumen using IVUS or double aortic lumen angiography is required. In presented cases, this technique was effective. |
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DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMSFENESTRAÇÃO DA LÂMINA DE DISSEÇÃO COM AGULHA TIPS, UMA TÉCNICA ADJUVANTE NO TRATAMENTO ENDOVASCULAR DE ANEURISMAS DISSECANTES DA AORTA TORACO-ABDOMINALChronic dissectionThoracoabdominal aortic aneurysmDissection flapFenestrationTIPS (transjugular intrahepatic portosystemic shunt) needleEndoprosthesisFenestrated/branched endovascular aortic repair (f/bEVAR)Disseção crónicaAneurisma da aorta toraco-abdominalFlap de disseçãoFenestraçãoAgulha TIPS (transjugular intrahepatic portosystemic shunt)EndopróteseFenestrated/branched endovascular aortic repair (f/bEVAR)Introduction: In chronic aortic dissection complicated with aneurysmal degeneration, there are commonly spontaneous tears between true and false lumen at the level of visceral arteries. However, in its absence or difficult identification, treatment with f/bEVAR is limited. In these, it may be required a fenestration procedure to allow visceral vessels access. Methods / Results: We present two case-reports of patients that underwent dissection flap fenestration procedures followed by f/bEVAR. In both patients, one-year follow-up CT scans show endoprosthesis and visceral branches patency, reduction of aneurysmal sac and absence of dissection or endoleaks. Conclusions: In fenestration creation, chronic dissection flap rigidity may require coarse devices with increased risk of aortic rupture, as TIPS needle. To prevent this complication, besides meticulous preoperative planning by CT angiography, intraoperative identification of true and false lumen using IVUS or double aortic lumen angiography is required. In presented cases, this technique was effective.Introdução: Na dissecção crónica complicada de degeneração aneurismática, é frequente existirem fendas espontâneas entre o verdadeiro e o falso lúmen ao nível das artérias viscerais. No entanto, na sua ausência ou difícil identificação, o tratamento com recurso a f/bEVAR está limitado. Nesses casos, pode ser necessária a criação de fenestrações para permitir o acesso aos vasos viscerais. Métodos / Resultados: Apresentam-se 2 casos de procedimentos de fenestração de lâmina de disseção crónica em doentes submetidos num segundo tempo a f/bEVAR. Em ambos os doentes, os exames de follow-up a 1 ano mostram permeabilidade das endopróteses e ramos viscerais da aorta, redução do saco aneurismático e ausência de sinais de disseção ou endoleaks. Conclusões: Na criação de fenestrações, a rigidez da lâmina de disseção crónica pode requer a utilização de dispositivos grosseiros com risco acrescido de rotura aórtica, como a agulha de TIPS. Para prevenir essa complicação, além do meticuloso planeamento pré-operatório por angio-TC, é essencial a correta identificação intra-operatória do verdadeiro e falso lúmen recorrendo a IVUS ou a angiografia do duplo lúmen aórtico. Nos casos apresentados, a referida técnica foi eficaz.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2021-09-10T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.352oai:ojs.acvjournal.com:article/352Angiologia e Cirurgia Vascular; Vol. 17 No. 2 (2021): June; 149-151Angiologia e Cirurgia Vascular; Vol. 17 N.º 2 (2021): Junho; 149-1512183-00961646-706Xreponame: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/352https://doi.org/10.48750/acv.352http://acvjournal.com/index.php/acv/article/view/352/253Copyright (c) 2021 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessCorreia, RicardoCatarino, JoanaVieira, IsabelBento, RitaGarcia, RitaPais, FábioRibeiro, TiagoCardoso, JoanaAlves, GonçaloBastos Gonçalves, FredericoFerreira, Maria Emília2022-05-23T15:10:11Zoai:ojs.acvjournal.com:article/352Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:42.535969Repositório 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 |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS FENESTRAÇÃO DA LÂMINA DE DISSEÇÃO COM AGULHA TIPS, UMA TÉCNICA ADJUVANTE NO TRATAMENTO ENDOVASCULAR DE ANEURISMAS DISSECANTES DA AORTA TORACO-ABDOMINAL |
title |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS |
spellingShingle |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS Correia, Ricardo Chronic dissection Thoracoabdominal aortic aneurysm Dissection flap Fenestration TIPS (transjugular intrahepatic portosystemic shunt) needle Endoprosthesis Fenestrated/branched endovascular aortic repair (f/bEVAR) Disseção crónica Aneurisma da aorta toraco-abdominal Flap de disseção Fenestração Agulha TIPS (transjugular intrahepatic portosystemic shunt) Endoprótese Fenestrated/branched endovascular aortic repair (f/bEVAR) |
title_short |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS |
title_full |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS |
title_fullStr |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS |
title_full_unstemmed |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS |
title_sort |
DISSECTION FLAP FENESTRATION WITH TIPS NEEDLE, AN ADJUVANT TECHNIQUE IN ENDOVASCULAR TREATMENT OF TORACOABDOMINAL AORTIC DISSECTING ANEURYSMS |
author |
Correia, Ricardo |
author_facet |
Correia, Ricardo Catarino, Joana Vieira, Isabel Bento, Rita Garcia, Rita Pais, Fábio Ribeiro, Tiago Cardoso, Joana Alves, Gonçalo Bastos Gonçalves, Frederico Ferreira, Maria Emília |
author_role |
author |
author2 |
Catarino, Joana Vieira, Isabel Bento, Rita Garcia, Rita Pais, Fábio Ribeiro, Tiago Cardoso, Joana Alves, Gonçalo Bastos Gonçalves, Frederico Ferreira, Maria Emília |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Correia, Ricardo Catarino, Joana Vieira, Isabel Bento, Rita Garcia, Rita Pais, Fábio Ribeiro, Tiago Cardoso, Joana Alves, Gonçalo Bastos Gonçalves, Frederico Ferreira, Maria Emília |
dc.subject.por.fl_str_mv |
Chronic dissection Thoracoabdominal aortic aneurysm Dissection flap Fenestration TIPS (transjugular intrahepatic portosystemic shunt) needle Endoprosthesis Fenestrated/branched endovascular aortic repair (f/bEVAR) Disseção crónica Aneurisma da aorta toraco-abdominal Flap de disseção Fenestração Agulha TIPS (transjugular intrahepatic portosystemic shunt) Endoprótese Fenestrated/branched endovascular aortic repair (f/bEVAR) |
topic |
Chronic dissection Thoracoabdominal aortic aneurysm Dissection flap Fenestration TIPS (transjugular intrahepatic portosystemic shunt) needle Endoprosthesis Fenestrated/branched endovascular aortic repair (f/bEVAR) Disseção crónica Aneurisma da aorta toraco-abdominal Flap de disseção Fenestração Agulha TIPS (transjugular intrahepatic portosystemic shunt) Endoprótese Fenestrated/branched endovascular aortic repair (f/bEVAR) |
description |
Introduction: In chronic aortic dissection complicated with aneurysmal degeneration, there are commonly spontaneous tears between true and false lumen at the level of visceral arteries. However, in its absence or difficult identification, treatment with f/bEVAR is limited. In these, it may be required a fenestration procedure to allow visceral vessels access. Methods / Results: We present two case-reports of patients that underwent dissection flap fenestration procedures followed by f/bEVAR. In both patients, one-year follow-up CT scans show endoprosthesis and visceral branches patency, reduction of aneurysmal sac and absence of dissection or endoleaks. Conclusions: In fenestration creation, chronic dissection flap rigidity may require coarse devices with increased risk of aortic rupture, as TIPS needle. To prevent this complication, besides meticulous preoperative planning by CT angiography, intraoperative identification of true and false lumen using IVUS or double aortic lumen angiography is required. In presented cases, this technique was effective. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-09-10T00:00:00Z |
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.352 oai:ojs.acvjournal.com:article/352 |
url |
https://doi.org/10.48750/acv.352 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/352 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/352 https://doi.org/10.48750/acv.352 http://acvjournal.com/index.php/acv/article/view/352/253 |
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. 17 No. 2 (2021): June; 149-151 Angiologia e Cirurgia Vascular; Vol. 17 N.º 2 (2021): Junho; 149-151 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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1799129849879592960 |