scholarly journals PP-355 Endovascular Stenting Extension of Elephant Trunk Surgical Graft to Lower Descending Thoracic Aorta in a Patient with Aortic Arch and Descending Aortic Aneurysm

2014 ◽  
Vol 113 (7) ◽  
pp. S150-S151
Author(s):  
V.V. Vijan ◽  
N. Mathew
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Descending Thoracic Aorta ◽  
Endovascular Stenting ◽  
Elephant Trunk ◽  
Descending Aortic Aneurysm

SUCCESFULL SURGICAL REPAIR OF AN ACCUTE TYPE A DISSECTING AORTIC ANEURYSM ASSOCIATED WITH A RIGHT-SIDED-AORTIC ARCH AND RIGHT SIDED DESCENDING THORACIC AORTA

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 416S ◽  
Author(s):  
Konstantinos E. Paziouros ◽  
Stavros Siminelakis ◽  
Sokrates Sismanidis ◽  
Leonidas Disnitsas ◽  
Miltiadis Matsagas ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Surgical Repair ◽  
Type A ◽  
Descending Thoracic Aorta ◽  
Dissecting Aortic Aneurysm

scholarly journals Comprehensive treatment of pathology of the ascending, arch and descending thoracic aorta by performing operations of the hybrid "elephant trunk"

2021 ◽  
Vol 25 (3 (99)) ◽  
pp. 42-47
Author(s):  
V. Kravchenko ◽  
I. Dytkivski ◽  
V. Lybavka
Keyword(s):  
Hospital Mortality ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Postoperative Blood Loss ◽  
Comprehensive Treatment ◽  
Descending Thoracic Aorta ◽  
Elephant Trunk ◽  
Surgical Equipment ◽  
Complete Replacement ◽  
Aortic Pathology

The purpose of the study – study and demonstration of the possibilities of the technique of complete replacement of the ascending, arch, vessels of the arch and descending thoracic aorta "elephant trunk" surgery in patients with aortic arch aneurysms.Material and methods. The paper describes the technique and demonstrates the results of the first 29 operations of prosthetics of the ascending, arch, vessels of the arch and descending thoracic aorta, which were performed by the staff of the Department of Surgical Treatment of Aortic Pathology National M.Amosov ICVS of the NAMS of Ukraine" in 2016-2020. Results. Hospital mortality was 10.3%, three patients died. The causes of death were: the following acute cardiovascular failure, uncontrolled bleeding, and multiple organ failure in each case. In none of the operated patients the level of postoperative blood loss did not require rethoracotomies.Conclusions. The optimal way to correct aneurysms of the aortic arch is the operation of prosthetics of the ascending, arch and descending thoracic aorta - "elephant trunk". Improvement of preoperative diagnostics, surgical equipment, optimization of methods of protection of the brain, spinal cord and visceral organs, the possibility of using hybrid / endovascular techniques to treat patients with complex lesions of the aortic arch pool with hospital mortality within 10.3%.

scholarly journals Frozen Elephant Trunk in Aortic Arch Disease: Different Devices for Different Pathologies

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1090
Author(s):  
Carlo Mariani ◽  
Giacomo Murana ◽  
Alessandro Leone ◽  
Luca Di Di Marco ◽  
Davide Pacini
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Stent Graft ◽  
Intramural Hematoma ◽  
Distal Anastomosis ◽  
Frozen Elephant Trunk ◽  
Descending Thoracic Aorta ◽  
Elephant Trunk ◽  
Remarkable Feature ◽  
Early Results

The frozen elephant trunk technique (FET) requires the use of a pre-assembled hybrid prosthesis consisting of a standard Dacron vascular portion to replace the aortic arch and a stent graft component, which is placed into the proximal descending thoracic aorta (DTA) anterogradely in the proximal descending thoracic aorta. In Europe, two hybrid prostheses are available: the E-evita Open Plus hybrid stent graft system provided by JOTEC (Hechingen, Germany) and the ThoraflexTM Hybrid (Vascutek, Inchinnan Scotland). Recommendations for use are extensive pathologies of the arch in case of acute and chronic aortic dissection, degenerative aneurysm and intramural hematoma. The FET approach allows the replacement of the whole arch in one stage with the option of direct treatment of the proximal descending thoracic aorta based on the stent component, creating a safe landing zone for further endovascular treatment more distally. The remarkable feature of this technique is the possibility to perform more proximally (from zone 3 to zone 0) the distal anastomosis in to the arch. This allows for an easier distal anastomosis, reduced hypothermic circulatory arrest time and decreased risk of paraplegia (<5%). Early results are promising and according to the most recent series the rate of developing post-operative renal insufficiency ranges from 3 to 10%, the risk of stroke from 3% to 8% and mortality from 8–15%. The aim of the article will be to provide some knowledge about the use and application of FET procedures in different aortic situations.

scholarly journals Recurrent Aortobronchial Fistula after Endovascular Stenting for Infected Pseudoaneurysm of the Proximal Descending Thoracic Aorta: Case Report

2021 ◽  
Vol 54 (5) ◽  
pp. 425-428
Author(s):  
Sun-Geun Lee ◽  
Seung Hyong Lee ◽  
Won Kyoun Park ◽  
Dae Hyun Kim ◽  
Jae Won Song ◽  
...  
Keyword(s):  
Case Report ◽  
Thoracic Aorta ◽  
Descending Thoracic Aorta ◽  
Endovascular Stenting ◽  
Aortobronchial Fistula ◽  
Infected Pseudoaneurysm

scholarly journals Treating the patient with acute rupture of penetrating atherosclerotic ulcer of the thoracic aorta

2015 ◽  
Vol 96 (3) ◽  
pp. 377-380
Author(s):  
I R Yagafarov ◽  
R R Sayfullin ◽  
M M Iskhakov ◽  
N V Gazizov ◽  
M G Khatypov ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Spontaneous Rupture ◽  
Open Surgery ◽  
Intraoperative Complications ◽  
Long Term Results ◽  
Safe Procedure ◽  
Descending Thoracic Aorta ◽  
Prosthetic Repair ◽  
Penetrating Atherosclerotic Ulcer

Spontaneous rupture of the aorta - a violation of the integrity of the aortic wall which is not caused by an aneurysm, trauma, dissection or disintegrating tumor process, and is an acute life-threatening condition. According to some authors, the main cause of spontaneous rupture of the aorta is a penetrating atherosclerotic ulcer of the aorta, which is an ulceration of aortic atherosclerotic plaque leading to penetration of the internal elastic plate in media. We present a case of successful hybrid surgical treatment of patient with spontaneous rupture of the descending thoracic aorta with the formation of para-aortic hematoma and left-sided hemothorax. The patient underwent a hybrid operation - aortic arch and descending thoracic aorta prosthetic repair, subclavian bypass with left subclavian artery ligation, left-sided thoracotomy, and pleural cavity sanitation. No intraoperative complications were observed, the patient was taken off the ventilator on day 2. The control computed tomography performed on day 10, revealed correct and stable stent graft position with no signs of continued bleeding, endoleak. The patient was discharged in satisfactory condition on day 14. Due to the high hospital mortality of open surgery on the thoracic aorta in case of penetrating atherosclerotic ulcers, as well as the predominance of elderly patients with severe comorbidities that contraindicate open surgery using cardiopulmonary bypass, endovascular and hybrid technologies, which are minimally invasive and traumatic, come to the fore. Endovascular prosthetic repair in case of penetrating atherosclerotic ulcer of aortic arch and descending thoracic aorta is an effective and safe procedure in patients at high risk, showing encouraging long-term results.

scholarly journals A New Methodology to Determine Apposition, Dilatation, and Position of Endografts in the Descending Thoracic Aorta After Thoracic Endovascular Aortic Repair

2019 ◽  
Vol 26 (5) ◽  
pp. 679-687 ◽  
Author(s):  
Kim van Noort ◽  
Richte C. L. Schuurmann ◽  
Gersom Post Hospers ◽  
Emma van der Weijde ◽  
Hans G. Smeenk ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aorta ◽  
Thoracic Aortic Aneurysm ◽  
Interobserver Agreement ◽  
Interobserver Variability ◽  
Thoracic Endovascular Aortic Repair ◽  
Descending Thoracic Aorta ◽  
Applied Software ◽  
Shortest Distance ◽  
The Mean

Purpose: To validate computed tomography angiography (CTA)–applied software to assess apposition, dilatation, and position of endografts in the proximal and distal landing zones after thoracic endovascular aortic repair (TEVAR) of thoracic aortic aneurysm. Materials and Methods: Twenty-two patients (median age 75.5 years; 11 men) with a degenerative descending thoracic aortic aneurysm treated with TEVAR with at least one postoperative CTA were selected from a single center’s database. New CTA-applied software was used to determine the available apposition surface in the proximal and distal landing zones, apposition of the endograft fabric with the aortic wall, shortest apposition length, endograft inflow and outflow diameters, shortest distance between the left subclavian artery and the proximal endograft fabric, and shortest distance between the celiac trunk and the distal endograft fabric on each CTA. Interobserver variability for these parameters was assessed with the repeatability coefficient and the intraclass correlation coefficient. Results: Excellent interobserver agreement was found for all measurements. Interobserver variability of surface and shortest apposition length calculations was larger for the distal site compared with the proximal site, with a mean difference of 10% vs 2% of the mean available apposition surface, 12% vs 5% of the endograft apposition surface, and 16% vs 8% of the shortest apposition length, respectively. Inflow and outflow diameters of the endograft showed low variability, with a mean difference of 0.1 mm with 95% of the interobserver difference within 1.8 mm. Mean interobserver differences of the proximal and distal shortest fabric distances were 1.0 and 0.9 mm (both 2% of the mean lengths). Conclusion: Assessment of apposition, dilatation, and position of the proximal and distal parts of an endograft in the descending thoracic aorta is feasible after TEVAR with the new software. Interobserver agreement for all measured parameters was excellent for the proximal and distal landing zones. The new method allows detection of subtle changes during follow-up. However, a larger study is needed to quantify how parameters change over time in complicated and uncomplicated TEVAR cases and to define the real added value of the new methodology.

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