scholarly journals Endovascular stent grafting of a penetrating ulcer in the descending thoracic aorta

2003 ◽  
Vol 25 (2) ◽  
pp. 178-179 ◽  
Author(s):  
J.S. Crane ◽  
M. Cowling ◽  
N.J. Cheshire
2003 ◽  
Vol 76 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Taijiro Sueda ◽  
Kazumasa Orihashi ◽  
Kenji Okada ◽  
Yuji Sugawara ◽  
Katsuhiko Imai ◽  
...  

2002 ◽  
Vol 9 (2_suppl) ◽  
pp. II-20-II-24 ◽  
Author(s):  
Peter L. Faries ◽  
Elvira Lang ◽  
Pranay Ramdev ◽  
Larry H. Hollier ◽  
Michael L. Marin ◽  
...  

Purpose: To describe a ruptured ulcer of the descending thoracic aorta treated with an endovascular stent-graft deployed under transesophageal echocardiographic (TEE) guidance. Case Report: An 82-year-old man with severe chronic obstructive pulmonary disease and congestive heart failure presented with sharp pain in the back radiating to the left flank. Computed tomography (CT) and angiography demonstrated a penetrating ulcer of the descending thoracic aorta associated with aortic dissection commencing 6 cm from the origin of the left subclavian artery with extravasation of contrast outside the aortic wall. The patient remained symptomatic with a decrease in hematocrit from 36% to 23%. Endovascular repair was performed using self-expanding nitinol stents sutured to a 35-mm × 12-cm Dacron conduit. The device was deployed with a 24-F delivery system under TEE guidance and fluoroscopy. Successful exclusion of the ruptured ulcer was demonstrated by TEE Doppler, arteriography, and CT. The patient remains asymptomatic 18 months after the procedure with no CT evidence of endoleak. Conclusions: Endovascular stent-graft repair under TEE guidance assists in the oftentimes difficult treatment of ruptured penetrating thoracic aortic ulcer.


2018 ◽  
pp. 135-140
Author(s):  
Kyaw K. Latt ◽  
Alexey A. Moiseev ◽  
Natalya R. Chernaya ◽  
Konstantin N. Vasilyev ◽  
Nikolay L. Bayandin ◽  
...  

Objective: to analyze the results of endovascular stent-graftingin dissections and atherosclerotic aneurysms of descending part of thoracic aorta.Material and method: in this analysis includes 28 patients with dissections and atherosclerotic aneurysms of descending part of thoracic aorta. Acute aortic dissection type 3 was occurred in 10 patients and two of them were complicated with rupture into the left pleural cavity. 10 patients with chronic aortic dissection type bunderwent operations and one of them was complicated with rupture into the left pleural cavity. Among 8 operated patients due to chronic aneurysms of descending part of thoracic aorta, 4 patients were manifested with symptoms of hemothorax. In 3 patients with aortic dissection type 1 in long-term period, endovascular stent-grafting was performed concerning with the dilatation of descending thoracic aorta and patent false lumen. During in-hospital and long-term periods immediate clinical results, serious clinical complications and long-term survival were compared.Results: technical success of endovascular stent-grafting was achieved in 100 % of cases. In-hospital mortality was 4 (14,2 %) and 30-day mortality was 3 (10,7 %). Events of paraplegia, TIA (Transient Ischemic Attack), prosthetic infection were not found in our research. Two clinical occurrences of vascular approach site complication were found; one case of endoleak type 1 and stent-graft dislocation which required repeated endovascular stent-grafting and one case of endoleak type 2 which was performed subclaviancarotid bypass and ligation of left subclavian artery. Prolong intubation was needed in 5 patients (18,5 %).conclusion: Endovascular stent-grafting in dissections and atherosclerotic aneurysms of descending part of thoracic aorta contributes good immediate clinical results associating with less quantity of serious complications.


2006 ◽  
Vol 81 (3) ◽  
pp. 1174-1176 ◽  
Author(s):  
Nicholas T. Kouchoukos ◽  
Joseph E. Bavaria ◽  
Joseph S. Coselli ◽  
Ralph De La Torre ◽  
John S. Ikonomidis ◽  
...  

2003 ◽  
Vol 10 (5) ◽  
pp. 928-931 ◽  
Author(s):  
Giuseppe D'Ancona ◽  
Richard Bauset ◽  
Jean-Pierre Normand ◽  
Roc Turcotte ◽  
François Dagenais

Purpose: To report a pitfall encountered during stenting of a complicated penetrating ulcer of the descending thoracic aorta. Case Report: A 65-year-old man was diagnosed with a complicated penetrating ulcer of the thoracic aorta. A 38-mm Talent endograft was implanted. On balloon dilation of the distal end of the endoprosthesis, the terminal bare stent became distorted and penetrated the aortic wall. A 42-mm endoprosthesis was immediately placed to exclude the aortic perforation. Control aortography demonstrated exclusion of the original proximal aortic ulcer and the distal iatrogenic aortic tear. Conclusions: Endoprostheses may present some drawbacks in terms of elasticity and adaptability to tortuous and angulated diseased aortas. Caution is advised in the treatment of penetrating aortic ulcers where the aortic wall is diffusely friable. In this condition, balloon dilation should be limited to the covered portion of the stent-graft to prevent stent distortion and erosion through the aortic wall.


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