Trans-Carotid Placement of Balloon Expandable Covered Stent for Unplanned Left Carotid Coverage during Endovascular Repair of Distal Arch Aneurysm

2015 ◽  
Vol 10 (3) ◽  
pp. 209-211
Author(s):  
Ganesh S. Kumpati ◽  
David A. Bull ◽  
Amit N. Patel
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Endovascular Repair ◽  
Common Carotid Artery ◽  
Covered Stent ◽  
Aortic Arch Aneurysm ◽  
Left Common Carotid Artery ◽  
Endovascular Management ◽  
Distal Aortic Arch Aneurysm ◽  
Arch Aneurysm

We present a technique for endovascular management of unplanned coverage of the left common carotid artery during endovascular repair of a distal aortic arch aneurysm. A balloon expandable covered stent was placed into the proximal left common carotid artery by neck incision.

Fenestrated TEVAR Using a Guidewire Fixator for Anchoring in Aortic Arch Target Vessels

2017 ◽  
Vol 25 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Tilo Kölbel ◽  
Linus Bosaeus ◽  
Nikolaos Tsilimparis ◽  
Franziska Heidemann ◽  
Fiona Rohlffs ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Endovascular Repair ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Left Common Carotid Artery ◽  
Target Vessel ◽  
Arch Aneurysm

Purpose: To report a new facilitated method for securing target vessel access during single fenestrated and branched thoracic endovascular repair using a guidewire fixator. Technique: The Liungman Guidewire Fixator (LGF) includes a 0.035-inch guidewire that is fitted with a stopper close to the distal end and a self-expanding anchoring element that is freely movable over the guidewire to the point of the stopper. The technique of using a LGF for anchoring in a target vessel is described in a 75-year-old woman with a 53-mm saccular arch aneurysm. She was treated with a fenestrated Zenith stent-graft that had a catheter-preloaded fenestration for the left subclavian artery (LSA) and a scallop for the left common carotid artery. To avoid through-and-through wire and brachial access, the LGF was used to secure the guidewire in the LSA during stent-graft deployment. Conclusion: The use of an LGF for anchoring in the target LSA during fenestrated arch endografting was feasible and safe.

scholarly journals A Rare Case of an Ascending Aorta and Aortic Arch Aneurysm with an Aberrant Right Common Carotid Artery

2021 ◽  
Vol 30 (1) ◽  
pp. 13-21
Author(s):  
Mikhail M. Olalo ◽  
Syril Bren P. Guillermo
Keyword(s):  
Back Pain ◽  
Chest Pain ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Incidental Finding ◽  
Aortic Arch Aneurysm ◽  
Aortic Aneurysms ◽  
Custom Made ◽  
Arch Aneurysm

Ascending aortic aneurysms are asymptomatic and are usually discovered as an incidental finding on chest imaging. However, larger aneurysms can present with symptoms resulting from compression of surrounding structures including the trachea, bronchi, and the esophagus which can result in hoarseness, cough chest pain or back pain. The presence of an aortic arch anomaly, specifically an aberrant right common carotid artery, in a background of an aortic arch aneurysm is extremely rare with a worldwide incidence of <1%. They are usually asymptomatic but can result to catastrophic life threatening events and pose significant challenges to surgical or endovascular treatment. This is a case of a 63-year old Filipino male who presented with a sudden onset of dull back pain radiating to the left anterior chest. Workup revealed an ascending and aortic arch aneurysm with an aberrant right common carotid artery arising directly from the transverse aorta. Surgical aortic arch debranching was done to repair the aberrant vessels prior to Thoracic Endovascular Aortic Repair (TEVAR) wherein a custom-made Thoracic Valiant graft was deployed on the aneurysm. The patient was discharged on the 4th day after TEVAR without any complaints of dyspnea, back pain nor chest pain with no neurologic and visceral organ dysfunction. This case has emphasized that knowledge on the anatomy of the aortic arch is imperative in planning out thoracic surgery and endovascular interventions especially on rare anatomic anomalies such as seen in this case. Keywords aortic aneurysm, aberrant right common carotid artery, TEVAR

scholarly journals Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alessandro Robaldo ◽  
Guido Carignano ◽  
Alberto Balderi ◽  
Claudio Novali
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
High Risk Patient ◽  
Carotid Bifurcation ◽  
Left Common Carotid Artery ◽  
The Right ◽  
Bovine Aortic Arch ◽  
Common Carotid Arteries

Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

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