Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer in a Patient with Renal Failure: A Case Report

2021 ◽  
Vol 14 (1) ◽  
pp. 88-92
Author(s):  
Abul Hasan Muhammad Bashar ◽  
Humayun Kabir ◽  
Mokhlesur Rahman ◽  
Md Ahsanul Alam
Keyword(s):  
Renal Failure ◽  
State Of The Art ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Descending Thoracic Aorta ◽  
Penetrating Aortic Ulcer ◽  
Considerable Cost ◽  
Aortic Repair ◽  
Aneurysm Dissection ◽  
Aortic Pathologies

Thoracic Endovascular Aortic Repair (TEVAR) is a state-of-the art endovascular intervention used to treat various thoracic aortic pathologies such as aneurysm, dissection and penetrating aortic ulcers (PAU). The procedure demands significant technical skill and involves considerable cost burden for the patients. The latter is the main reason why the procedure has not yet made it to the routine clinical practice in Bangladesh. We recently performed TEVAR for the successful treatment of an ominous-looking PAU in the descending thoracic aorta in a patient with renal failure. Cardiovasc j 2021; 14(1): 88-92

scholarly journals Outcomes of single physician-modified fenestrated stent grafts for endovascular repair of thoracic aortic lesions involving the distal aortic arch

2020 ◽  
Author(s):  
Jiechang Zhu ◽  
Chao Ma ◽  
Xiangchen Dai ◽  
Zheng Wang ◽  
Hailun Fan ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Stent Grafts ◽  
Aortic Repair ◽  
Type B Dissection ◽  
Aortic Pathologies ◽  
Aortic Lesions

Abstract OBJECTIVES Our goal was to evaluate the outcomes of fenestrated thoracic endovascular aortic repair of thoracic aortic lesions involving the distal aortic arch using single physician-modified stent grafts. METHODS This single-centre, retrospective study included 58 consecutive patients (mean age, 57 ± 14 years; 11 women) who underwent fenestrated thoracic endovascular aortic repair for thoracic aortic pathologies involving the distal aortic arch using single physician-modified stent grafts between November 2015 and December 2018. Indications included complicated acute type B dissection or intramural haematoma with an unfavourable proximal landing zone (n = 49), type Ia endoleak subsequent to thoracic endovascular aortic repair due to acute type B dissection (n = 1) and distal arch degenerative aneurysms <15 mm from the left subclavian artery (n = 8). RESULTS The technical success rate was 94.8%. The 30-day mortality was 1.7%, and the perioperative ischaemic stroke rate was 1.7%. The incidence of perioperative complications was 10.3%. At a mean follow-up of 26.3 months (range, 7–44), all target vessels were patent. All-cause mortality was 5.2%. Estimated 1-, 2- and 3-year survival was 98.3 ± 1.7%, 96.4 ± 2.5% and 93.2 ± 3.9%, respectively. CONCLUSION The single fenestrated stent graft technique is feasible and effective for endovascular repair of thoracic aortic pathologies involving the distal aortic arch.

scholarly journals Sex-Based Differences in Outcomes After Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer and Intramural Hematoma

2021 ◽  
Vol 74 (3) ◽  
pp. e116-e117
Author(s):  
Priya Patel ◽  
Christina Marcaccio ◽  
Livia de Guerre ◽  
Virendra I. Patel ◽  
Marc L. Schermerhorn ◽  
...  
Keyword(s):  
Intramural Hematoma ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Penetrating Aortic Ulcer ◽  
Aortic Repair

Evaluation of EndoAnchor Aortic Wall Penetration After Thoracic Endovascular Aortic Repair

2020 ◽  
Vol 27 (2) ◽  
pp. 240-247
Author(s):  
Andrés Reyes Valdivia ◽  
Sara Busto Suárez ◽  
África Duque Santos ◽  
Ahmad Amer Zanabili Al-Sibbai ◽  
Claudio Gandarias Zúñiga ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Aortic Wall ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Descending Thoracic Aorta ◽  
Aortic Repair ◽  
Type Ia ◽  
Endograft Infection ◽  
Academic Vascular Surgery

Purpose: To analyze aortic wall penetration of Heli-FX EndoAnchors after use in seal zones in the aortic arch or descending thoracic aorta during thoracic endovascular aortic repair (TEVAR). Materials and Methods: From May 2014 to May 2019, 25 patients (mean age 70.5±10 years; 16 women) were treated with TEVAR and adjunctive use of the Heli-FX device in 3 academic vascular surgery departments. Computed tomography scans were retrospectively reviewed to determine the location [arch or descending thoracic aorta (DTA)] of the EndoAnchors and the adequacy of aortic wall penetration, defined as adequate (≥2 mm), partial (<2 mm), or inadequate wall penetration (including loss). Endoleaks, reinterventions, and mortality were assessed. Results: A total of 161 EndoAnchors were deployed (median 7 per patient, range 4–9). Twenty-two EndoAnchors were place in the arch (zones 0–2) and 139 in the DTA (zones 3–5). A larger proportion of arch deployments (27%) had suboptimal penetration compared with the DTA (6.5%; p<0.005), resulting in a 91% adequate wall penetration rate for the series overall. Three EndoAnchors were lost (and only 1 retrieved) in 3 different patients, with no additional morbidity; thus, an overall deployment success rate of 88% was achieved. At a mean follow-up of 16.6±14 months, 4 patients required 5 (successful) reinterventions, including one for a type Ia endoleak treated with chimney TEVAR. One patient died 10 months after treatment due to endograft infection, without an opportunity for surgical correction. Conclusion: EndoAnchors have a higher risk of maldeployment in the arch, though this may be attributable to the small learning curve experience in this location. The best aortic wall penetration for this series was in the DTA, where EndoAnchors proved useful for distal endograft fixation during TEVAR.

scholarly journals Valiant NAVION Stent Graft System Application: First Asian Case Series Analysis

2020 ◽  
Author(s):  
Chi Ying Simon Chow ◽  
Yan Kit Ho ◽  
Takuya Fujikawa ◽  
Kevin Lim ◽  
Cheuk Man Chu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Stent Graft ◽  
Case Series ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Technical Success ◽  
Term Survival ◽  
Aortic Repair ◽  
The Mean ◽  
Aortic Pathologies

Background and aim of the study The Valiant NavionTM stent graft system is a third-generation low profile thoracic endograft designed for thoracic endovascular aortic repair. In this population analysis, we report on the first Asian all-comers experience and outcomes who underwent thoracic endovascular aortic repair with the use of this new stent graft system. Methods Between May 2019 and October 2020, 21 patients with different aortic pathologies were prospectively recruited and retrospectively analyzed. Important clinical and device-related outcomes were evaluated. The endpoints included short-term survival, technical success, access failures, major vascular and clinical complications, endoleaks, and hospital stay. Results The commonest indication of stenting was penetrating aortic ulcers (28.6%) and 6 (28.6%) patients had emergency stenting performed for aortic transection or rupture. 30 days of survival post-procedure was recorded and complete. There were no major vascular complications. Deployment accuracy was 100%, and the technical success rate was 94.7% (18/19) with 1 patient having a type 2 endoleak on follow-up imaging. No neurological complications were noted. The mean operative time was 95 +/- 73.6 mins and the mean fluoroscopy time was 16.2 +/- 10.8 mins. Mean hospital stay for elective zone 2, 3 and 4 stenting was 5.3 +/- 3.8 days, and only 1 patient post zone 1 TEVAR required a brief (0.5 days) ICU stay. All procedures were performed via the percutaneous transfemoral route with 100% success in percutaneous closure. Conclusion This first reported Asian case series demonstrated versatility, safety, and efficacy of the Valiant NavionTM stent in Asian patients with different aortic pathologies

Esophageal necrosis after endovascular repair for ruptured aortic dissection

2016 ◽  
Vol 25 (9) ◽  
pp. 638-641 ◽  
Author(s):  
Shintaro Koizumi ◽  
Seiichi Yamaguchi ◽  
Soichi Asano ◽  
Hisanori Fujita ◽  
Tomonori Sueta ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Management Strategy ◽  
False Lumen ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Descending Thoracic Aorta ◽  
Fatal Complication ◽  
Esophageal Necrosis ◽  
Aortic Repair ◽  
The Right

A 78-year-old man presented with back pain and shock and was transferred to our hospital. Computed tomography showed a ruptured aortic dissection in which the false lumen was thrombosed with an ulcer-like projection, and the mid-esophagus was shifted to the right due to a mediastinal hematoma. He underwent emergency thoracic endovascular aortic repair of the descending thoracic aorta. One week later, esophageal necrosis occurred, and he died of mediastinitis and sepsis on postoperative day 16. Although esophageal necrosis is a rare and fatal complication after thoracic endovascular aortic repair, a management strategy has not yet been established.

Sign in / Sign up

Export Citation Format

Share Document