Introduction. Hybrid procedures represent staged or simultaneous endovascular
and open surgical techniques in the treatment of complex pathologies of the
thoracic and abdominal aorta. We are presenting a patient with previous
abdominal aortic surgery in whom hybrid vascular procedure for descending
aorta and left subclavian artery aneurysm was performed. Case Outline. A
63-year-old female patient was admitted for computed tomography angiography.
Descending aorta aneurysm (7.6 cm) as well as aneurysm of the left subclavian
artery (LSA) was noted. Eight years ago she underwent abdominal aortic
aneurysm resection and aortoiliac bypass. Standard TEVAR (thoracic
endovascular aortic repair) procedure couldn?t be done due to small
dimensions of previous ?Y? graft (12.6 mm), so first we did LSA transposition
and after three days hybrid procedure. After ?Y? graft exposure, anastomosis
between the corps of ?Y? graft and tubular graft 10 mm was created and
through this conduit thoracic stent-graft was placed followed by complete ?Y?
graft replacement. After 6 months angiography showed regular postoperative
findings. Conclusion. Combined surgical and endovascular procedures in
thoracic aorta pathology treatment could be useful solutions with favorable
outcome.
A diagnostic odyssey and successful repair of a progressive aneurysmal expansion after complex aortic surgery and stent grafting of the descending aorta