Endovascular Treatment of Acquired Atheromatous Postsubclavian Aortic Coarctation

Coral reef aorta is a rare calcifying obstructive disease that involves the thoracoabdominal aorta. Similar presentations in the postsubclavian aorta may result in acquired atheromatous aortic coarctation leading to systemic hypertension and heart failure. The associated calcification makes surgical anatomic or extraanatomic bypass and thromboendarterectomy challenging. Extensive circumferential calcification often precludes endovascular intervention. We present the case of a 25-year-old man with an acquired atheromatous coarctation of the postsubclavian aorta who underwent successful endovascular treatment with use of a balloon-expandable covered stent.

A complex case of aortic arch interruption and hypoplastic descending aorta

The case of a newborn with a post-ductal interrupted aortic arch combined with severe hypoplasia of the thoracic descending aorta and intracardiac defects is described. Extraanatomic bypass surgery was performed in the neonatal period to connect the ascending and descending parts of the aorta. Closure of a ventricular septal defect and excision of hypertrophied bands in the right ventricle with subsequent ventriculotomy were delayed beyond neonatal age.

TORACOBIFEMORAL BYPASS IN A PATIENT WHO UNDERWENT REPEATED INTERVENTIONS ON THE AORTO-FEMORAL SEGMENT DUE TO ATHEROSCLEROTIC LESIONS

Aortobifemoral bypass is still the gold standard treatment in surgery of the aortofemoral segment. The 1980s – 1990s classic publications showed that primary patency ranges from 76–95% in 5 years, and 75–85% in 10-years [1, 2]. Thrombosis of both branches of the bifurcation prosthesis occurs in 1–4% of patients. These patients may undergo thrombectomy with reconstruction of the distal anastomoses, re-aortofemoral prosthetics and, finally, extraanatomic bypass surgery.

BYPASS SURGERY IN PATIENTS WITH COMBINED ATHEROSCLEROTIC LESIONS OF COMMON AND INTERNAL CAROTID ARTERY

An analysis of data of carotid angiographies was made in 146 patients with chronic cerebrovascular disease. Combined lesions of the common and internal carotid artery with clinical signs were revealed in 2 (1,4%) patients. A crossed extraanatomic bypass from the left common carotid artery to the right internal carotid artery was performed in one patient. The orthotopic common-internal autovenous bypass on the right side was carried out for another patient. According to obtained results, the authors suggested that the orthotopic or extraanatomic common-internal carotid artery bypasses could be applied in case of impossibility of endovascular intervention, when patients had the combined atherosclerotic lesions of common carotid and internal carotid artery.