A ruptured thoracoabdominal aortic aneurysm is an urgent situation requiring emergency surgery during which it is necessary to decrease the scope of the intervention in a patient at an extremely high surgical risk. A combination of surgical and endovascular techniques makes it possible to minimize surgical injury, blood loss, to shorten the duration of internal organs ischaemia, to reduce the risk of paraplegia. Presented herein are the results of emergency hybrid intervention for a ruptured thoracoabdominal aortic aneurysm, accompanied and followed by description of the technical aspects of performing the surgical and endovascular stages. The early postoperative period was complicated by thrombosis of the left superficial femoral artery on the background of atherosclerotic lesions, which was successfully eliminated by means of endovascular intervention with endovascular prosthetic repair. After 10 months, the patient underwent a cardiosurgical intervention. Combining surgical and endovascular techniques made it possible in an emergency situation to save the patient's life and to provide its good quality in the remote period of follow up (4 years after the hybrid operation).
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J Clin Med
January 2025
Department of Vascular Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
: The parallel stent graft endovascular aortic repair (PGEVAR) technique is an off-the-shelf option used for elective complex abdominal aortic aneurysm repair with acceptable outcome results, as reported so far. The PGEVAR technique, using chimney or periscope parallel grafts, can also be used for patients with ruptured complex abdominal aortic aneurysms. However, only few data about the mid- to long-term outcomes are available.
View Article and Find Full Text PDFBackground And Aims: An arterial aneurysm is characterized by a localized expansion of a blood vessel relative to its original dimensions. Specifically, an abdominal aortic aneurysm (AAA) is identified as an aortic diameter measuring at least one and a half times the standard diameter at the renal artery level, approximately equivalent to 2.0 cm.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Vascular Surgery and Transplantation, Medical University of Bialystok, 15-276 Bialystok, Poland.
Stent-graft implantation is a widely recognized method for endovascular treatment of aortic aneurysms. In cases where the aneurysm involves the thoracic and abdominal aorta, repair including fenestrated and branched stent grafts provides a viable alternative. This approach, initially reserved for patients unsuitable for open surgery, has become preferred for anatomically appropriate thoracoabdominal aortic aneurysms.
View Article and Find Full Text PDFEur J Vasc Endovasc Surg
December 2024
Division of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Objective: Emergent complex abdominal aortic diseases are challenging to treat. During in situ laser fenestration (ISLF), aortic branches are covered and flow is restored with in situ fenestration of the stent graft, with promising midterm results. This study aimed to expand on the limited body of knowledge of midterm outcomes of ISLF in renovisceral aortic pathology in a multicentre setting.
View Article and Find Full Text PDFKyobu Geka
December 2024
Department of Thoracic and Cardiovascular Surgery, Saga University, Saga, Japan.
We report a rare case of rupture without bleeding secondary to endotension after thoracic endovascular aneurysm repair. An 82-year-old woman had undergone multiple thoracic endovascular aortic repairs for a distal arch aneurysm. Due to the aneurysm enlargement, stent graft was eventually placed from the ascending aorta to just above the celiac artery after axillo-axillo-common carotid artery bypass.
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