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Thoracic Aortic Stents: a Combined Solution for Complex Cases

2002; Elsevier BV; Volume: 24; Issue: 5 Linguagem: Inglês

10.1053/ejvs.2002.1687

1532-2165

S Saccani, Francesco Nicolini, Cesare Beghi, Carla Marcato, Mario Uccelli, P Larini, Alessandro Maria Budillon, Andrea Agostinelli, Tiziano Gherli,

Infectious Aortic and Vascular Conditions

The combination of endovascular and standard surgical techniques may facilitate the management of complex aortic disease although the long-term durability of this approach needs to be confirmed.A retrospective review of our experience in the treatment of patients with complex aortic pathology using a combined endovascular and surgical approach.Between 1998 and 2001, 27 patients with thoracic aortic aneurysm underwent stent-graft implantation. Eight required combined endovascular and surgical procedure because of complex pathology. In 3 cases, combined repair was carried out for a concomitant abdominal aortic aneurysm or aorto-iliac-femoral occlusive disease. In the other 5 cases, vessel relocation was performed to obtain safe landing zones: left subclavian artery to left carotid artery translocation in 3 patients, celiac trunk to superior mesenteric artery translocation in one and aorto-celiac-mesenteric bypass grafting in one.One of the 8 patients died on 12th post-operative day of intestinal bleeding and bowel infarction. No neurological sequelae were reported. The other patients are currently well at 11 months mean follow-up time.Simultaneous surgical and endovascular procedure is a feasible and may be a valuable adjunct to the treatment of complex aortic and peripheral vessel anatomy.