Axial views of the preoperative contrasted CT Aorta demonstrating the total arch and descending thoracic aorta endovascular repair with ZenithTM Arch and Alpha distal extension modular stents (Cook) finishing above the visceral segment. Note the residual chronic aneurysm sac within the descending thoracic aorta, without the presence of any endoleaks. Due to the stent graft infection there is a dislocation of the innominate artery stent branch and an expanding aneurysm on the same vessel.

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 366-366
Author(s):  
Ana Lopez-Marco ◽  
Saleem Jahangeer ◽  
Benjamin Adams ◽  
Aung Ye Oo
Keyword(s):  
Thoracic Aorta ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Graft Infection ◽  
Innominate Artery ◽  
Descending Thoracic Aorta ◽  
Distal Extension

Endovascular Repair of the Descending Thoracic Aorta: Evidence for the Change in Clinical Practice

Vascular ◽  
2005 ◽  
Vol 13 (3) ◽  
pp. 148-157 ◽  
Author(s):  
Saiqa Sayed ◽  
Matt M. Thompson
Keyword(s):  
Thoracic Aorta ◽  
Endovascular Repair ◽  
Graft Infection ◽  
Aortic Disease ◽  
Outcome Data ◽  
Aortic Aneurysms ◽  
Descending Thoracic Aorta ◽  
Thoracic Aortic Disease ◽  
Technical Success Rate ◽  
Open Conversion

The purpose was to review outcome data following endovascular repair of the descending thoracic aorta from reports published between 1994 and 2004. To accomplish this task, 1,518 patients underwent endovascular repair for thoracic aortic disease; 810 thoracic aortic aneurysms, 500 type B thoracic aortic dissections, and 106 traumatic ruptures. The 30-day mortality rate was 5.5% and 6% for late postoperative deaths. The primary technical success rate was 97%, with only 15 patients requiring open conversion. Neurologic deficits occurred in 29 patients. In total, 118 endoleaks were reported; 29 were restented, and the remainder required surgical intervention. Graft infection occurred in 6 cases, and migrations were detected in 10. The conclusion reached is that endovascular repair of descending thoracic aortic disease is feasible and can be achieved with low rates of perioperative morbidity and mortality. As few long-term data exist on the durability of thoracic stent grafts, lifelong surveillance remains necessary.

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.

Penetrating atherosclerotic ulcer aneurysm of the innominate artery

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Yuan ◽  
Tager
Keyword(s):  
Conservative Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Innominate Artery ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Descending Aorta

Penetrating atherosclerotic ulcer of the aorta is uncommon, and usually develops in the descending thoracic aorta. Rarely this condition involves the branch vessels of the aorta. We report a case of ruptured aneurysm of the innominate artery resulting from penetrating atherosclerotic ulcer. Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta.

Penetrated Descending Thoracic Aorta After Blunt Chest Trauma: Successful Endovascular Repair

2009 ◽  
Vol 66 (3) ◽  
pp. E36-E38 ◽  
Author(s):  
Ian F. Faneyte ◽  
J Carel Goslings ◽  
Krijn P. van Lienden ◽  
Mirza M. Idu
Keyword(s):  
Thoracic Aorta ◽  
Endovascular Repair ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Descending Thoracic Aorta

scholarly journals Endovascular Repair for Retrograde Type A Intramural Haematoma with Intimal Tear in the Descending Thoracic Aorta

2020 ◽  
Vol 60 (3) ◽  
pp. 386-393 ◽  
Author(s):  
Okano Ryoi ◽  
Chia-Hsun Lin ◽  
Jian-Ming Chen ◽  
Yung-Kun Hsieh ◽  
Shoei-Shen Wang ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Endovascular Repair ◽  
Type A ◽  
Intramural Haematoma ◽  
Descending Thoracic Aorta ◽  
Intimal Tear

Can the Left Subclavian Artery be Safely Covered during Endovascular Repair of the Descending Thoracic Aorta?

2008 ◽  
Vol 3 (3) ◽  
pp. 147-150 ◽  
Author(s):  
Ourania Preventza ◽  
Grayson H. Wheatley ◽  
James Williams ◽  
Hannan Chaugle ◽  
Kakra Hughes ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Subclavian Artery ◽  
Endovascular Repair ◽  
Left Subclavian Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Descending Thoracic Aorta ◽  
Complete Coverage ◽  
Internal Mammary

Objective Routine preoperative carotid-subclavian bypass or transposition is frequently recommended in patients undergoing endovascular repair of the descending thoracic aorta (DTA). We reviewed our comprehensive thoracic endografting experience with regards to coverage of the left subclavian artery (LSA) to assess whether mandatory preoperative carotid-subclavian bypass or transposition is necessary. Methods Between February 2000 and November 2005, 255 patients were successfully treated with an endoluminal graft (ELG) to the DTA. Indications for intervention included atherosclerotic aneurysms (109/255, 42.7%), acute and chronic dissections (75/255, 29.4%), miscellaneous (41/255, 16.1%), and penetrating aortic ulcers (30/255, 11.8%). There were 151 males (151/255, 59.2%) and 104 females (104/255, 40.8%) with a mean age of 71 years (range, 23–91 years). Results The LSA was completely covered with an ELG in 71 patients (71/255, 27.8%) and partially covered in 47 patients (47/255, 18.4%). In patients who had complete coverage of the LSA, 30 patients (30/71, 42.3%) had acute or chronic Type B dissections, 26 patients (26/71, 36.6%) had aneurysms, 11 patients (11/71, 15.5%) had miscellaneous aortic pathologies, and 4 patients (4/71, 5.6%) had pseudoaneurysms associated with prior coarctation repair. Fifteen patients (15/255, 5.9%) underwent preoperative carotid-subclavian bypass or transposition and subsequently underwent complete coverage of the LSA with an ELG. One patient (1/56, 1.8%) with complete coverage of the LSA required elective postoperative carotid-subclavian bypass secondary to left arm claudication. Conclusions Routine preoperative carotid-subclavian bypass is not necessary, except in select patients with a patent left internal mammary artery to the left anterior descending artery bypass graft or contralateral vertebral artery disease.

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