Emergent endovascular repair of a ruptured ascending aorta pseudoaneurysm with thoracic aortic stent graft

2021 ◽  
Author(s):  
Franklin Hanna Quesada ◽  
Franklin Hanna Rodríguez ◽  
Francesco Moroni ◽  
Andrés Marín ◽  
James Nieto ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Ascending Aorta ◽  
Aortic Stent Graft

Primary Endovascular Repair of the Ascending Aorta

2018 ◽  
Vol 13 (6) ◽  
pp. 448-450
Author(s):  
Bruno Borrello ◽  
Davide Carino ◽  
Andrea Agostinelli ◽  
Alessandro Maria Budillon ◽  
Francesco Nicolini
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Open Surgery ◽  
Case Series ◽  
Ascending Aorta ◽  
Off Label

Different case series have been published demonstrating the feasibility of endovascular repair of the ascending aorta in selected patients deemed unfit for open surgery. However, the use of commercially available stent graft in the ascending aorta remains off-label, and their excessive length often prevents their deployment in the ascending aorta. Here we report a case of successful primary endovascular repair of the ascending aorta using a physician modified off-the-shelf device.

Development of a Branched Stent-Graft for Endovascular Repair of Aortic Arch Aneurysms

2003 ◽  
Vol 10 (5) ◽  
pp. 940-945 ◽  
Author(s):  
Timothy A.M. Chuter ◽  
David G. Buck ◽  
Darren B. Schneider ◽  
Linda M. Reilly ◽  
Louis M. Messina
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Insertion Site ◽  
High Risk Patient ◽  
Innominate Artery ◽  
Short Side ◽  
Short Branch ◽  
Aortic Stent Graft ◽  
Arch Aneurysm

Purpose: To develop a branched stent-graft for endovascular repair of aortic arch aneurysm. Methods: Four different prototypes of a branched aortic stent-graft were inserted into a rubber model of the human aortic arch under fluoroscopic guidance. Each prototype was tested, modified, and tested again through a series of 4 iterations. The first 3 prototypes had multiple short side branches, as docking sites for extensions into the branches of the aortic arch. The last iteration had only 1 short branch for an extension into the distal aorta and 1 long branch for direct perfusion of the innominate artery. Results: With every re-design, the prototype aortic stent-graft became shorter, and its insertion site moved to a more proximally located arch artery. Stent-graft insertion, orientation, and extension also became quicker and easier with each change in device design. However, the only system to perform reliably was the last, which was subsequently used to treat a large, symptomatic pseudoaneurysm of the aortic arch in a high-risk patient. Conclusions: None of our multibranched systems was simple, safe, or durable enough for insertion into the aortic arch; only an iteration that had a short branch for an extension into the distal aorta and a long branch for direct perfusion of the innominate artery could be deployed without difficulty or delay.

Endovascular Hybrid Repair of True Ascending Aortic Aneurysms Using Double Graft Wrapping to Prepare a Landing Zone for Ascending Aortic Stent-Graft Placement: A Cohort Study

2019 ◽  
Vol 26 (5) ◽  
pp. 658-664 ◽  
Author(s):  
Ralf Kolvenbach ◽  
Ron Karmeli ◽  
Assaf Rabin ◽  
Raluca Lica
Keyword(s):  
Cardiopulmonary Bypass ◽  
Stent Graft ◽  
Ascending Aorta ◽  
Hybrid Procedure ◽  
Aortic Aneurysms ◽  
Graft Placement ◽  
Landing Zone ◽  
Aortic Stent Graft ◽  
Hybrid Repair

Purpose: To describe a hybrid procedure that avoids cardiopulmonary bypass to treat patients with true ascending aortic aneurysms without a suitable proximal landing zone for endovascular repair. Material and Methods: Thirteen consecutive patients (mean age 75.9±6.5 years; 8 women) with true ascending aortic aneurysms were treated with the endovascular hybrid repair of true aortic aneurysms (EHTA) approach, which consists of a conventional sternotomy with double wrapping of the ascending aorta followed by staged stent-graft placement. Via sternotomy, a polypropylene mesh trimmed to downsize the aneurysm is placed around the dilated ascending aorta and sutured to the adventitia. A similarly trimmed polytetrafluoroethylene graft is placed loosely around the first wrap to avoid adhesions and secure the proximal landing zone. There is no need for cardiopulmonary bypass. A few days later, a standard thoracic stent-graft is deployed via either a transaxillary or transfemoral access; chimney or bypass grafts are used as needed to revascularize the supra-aortic vessels. Results: The ascending aortic diameter was reduced from a mean 5.7 cm (range 4.8–6.5) to 3.9 cm (range 3.2–4.3) after wrapping. The mean interval between surgery and stent-graft placement was 5 days. In this interval, 2 patients with significant reduction in the diameter of the ascending aorta elected to forego placement of a stent-graft. Of the 11 patients who underwent the full hybrid EHTA procedure, the ascending aortic stent-graft was combined with a chimney graft in the innominate artery in 4 cases. In 1 patient, a supra-aortic debranching procedure using a bifurcated Dacron graft to the innominate and left common carotid arteries was performed after wrapping with the polypropylene mesh. There was no mortality or neurological complication. A sternal wound infection required a prolonged hospital stay. At a mean follow-up of 13.8 months (range 3–24), there has been no death, type I endoleak, or sign of aneurysm enlargement on imaging. Conclusion: This technique permits complete endovascular exclusion of an ascending aortic aneurysm in a less invasive approach than standard open repair. Although this is only a small cohort of patients without long-term follow-up, it seems that this hybrid procedure is associated with low morbidity and mortality. It offers a beating-heart approach to treat true ascending aortic aneurysms in selected high-risk patients.

False Aneurysms at Both Ends of a Descending Thoracic Aortic Stent-Graft: Complication after Endovascular Repair of a Penetrating Atherosclerotic Ulcer

2003 ◽  
Vol 10 (2) ◽  
pp. 249-253 ◽  
Author(s):  
Fang Hong Chen ◽  
Won Heum Shim ◽  
Byung Chul Chang ◽  
Sang Joon Park ◽  
Jong Yun Won ◽  
...  
Keyword(s):  
Case Report ◽  
Thoracic Aorta ◽  
Stent Graft ◽  
Acute Phase ◽  
Endovascular Repair ◽  
Unusual Complication ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Aortic Stent Graft

Purpose: To report the formation of false aneurysms at both ends of a stent-graft implanted in the descending thoracic aorta to repair a penetrating atherosclerotic ulcer. Case Report: A 66-year-old woman with a penetrating atherosclerotic ulcer was treated with a 34 × 70-mm homemade Gianturco-type stent covered with polytetrafluoroethylene graft. Four months later, she developed false aneurysms at both ends of the stent-graft. The patient refused further endovascular repairs, so the stent-graft was surgically removed and the aorta repaired. Conclusions: This case demonstrates an unusual complication that should be anticipated when a stent-graft is deployed in the acute phase of thoracic aortic ulcer or its variants.

Endovascular Treatment of a Symptomatic Suture Aneurysm Caused by an Aortic Isthmus Restenosis

Vascular ◽  
2006 ◽  
Vol 14 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Reinhard Kopp ◽  
Eckart Kreuzer ◽  
Martin Oberhoffer ◽  
Karin Anna Herrmann ◽  
Karl-Walter Jauch ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Late Complications ◽  
Aortic Isthmus ◽  
Aortic Stent Graft ◽  
Risk Of Rupture ◽  
Valuable Treatment ◽  
Long Term Follow Up ◽  
Intraoperative Balloon Dilatation

After operative treatment of aortic isthmus stenoses, late complications, such as aneurysm formation or aortic restenosis, might occur, with relevant morbidity and mortality rates during open surgical reintervention. We report on the endovascular repair of a symptomatic suture aneurysm caused by an aortic isthmus restenosis by thoracic aortic stent graft implantation and additional intraoperative balloon dilatation. Based on our experience, endovascular repair of thoracic aortic aneuryms caused by native aortic isthmus stenosis or postcoarctation restenosis is a valuable treatment option, especially in symptomatic patients with an imminent risk of rupture or a difficult immediate transthoracic surgical approach. Long-term follow-up is required to assess the durability of the stent graft treatment.

scholarly journals A Novel In Vitro Model Predicts Aortic Stent Graft Hemodynamic Alterations After Endovascular Repair

2015 ◽  
Vol 62 (5) ◽  
pp. 1376
Author(s):  
Robert D. Shepherd ◽  
Elena S. Di Martino ◽  
Steven K. Boyd ◽  
Randy D. Moore ◽  
Kristina D. Rinker
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
In Vitro Model ◽  
Aortic Stent Graft ◽  
Vitro Model

A Modular Multi-Branched System for Endovascular Repair of Bilateral Common Iliac Artery Aneurysms

2003 ◽  
Vol 10 (2) ◽  
pp. 203-207 ◽  
Author(s):  
Cherrie Z. Abraham ◽  
Linda M. Reilly ◽  
Darren B. Schneider ◽  
Shelley Dwyer ◽  
Rajiv Sawhney ◽  
...  
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Endovascular Repair ◽  
External Iliac Artery ◽  
Modular System ◽  
Iliac Aneurysm ◽  
Short Limb ◽  
Aortic Stent Graft ◽  
Internal Iliac ◽  
The Right

Purpose: To describe a modular stent-graft for cases of bilateral common iliac aneurysm. Technique: The aortic aneurysm is repaired using a standard bifurcated modular system (Zenith). A modified bifurcated component is deployed with its trunk in one limb of the original aortic stent-graft, its long limb in the external iliac artery, and its short limb in the iliac aneurysm just above the internal iliac orifice. A flexible extension is introduced from the right brachial artery and used to bridge the gap between the short limb of the modified bifurcated component and the left internal iliac artery. Conclusions: Endovascular repair of bilateral iliac aneurysm is feasible using a modular stent-graft with separate branches to the internal and external iliac arteries.

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