scholarly journals Antegrade Hybrid Chimney TEVAR Endograft in a Patient with Blunt Aortic Injury: A Challenging Case with Technical Success but Unfavorable Result

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Fotios Eforakopoulos ◽  
Maria Giovani ◽  
Petros Zampakis ◽  
Christina Kalogeropoulou ◽  
Fotini Fligou ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Aortic Injury ◽  
Ascending Aorta ◽  
Hybrid Technique ◽  
Stent Grafts ◽  
Landing Zone ◽  
Advantages And Disadvantages ◽  
Blunt Aortic Injury ◽  
Artery Disease ◽  
Hypothermic Arrest

Thoracic Endovascular Aortic Repair (TEVAR) has modified aortic medicine, particularly in patients with traumatic aortic injury (TAI). Conventional repair of TAI in the aortic arch is technically demanding as it requires cardiopulmonary bypass and deep hypothermic arrest with still a significant number of complications. Despite recent improvements in endovascular techniques, many patients have been excluded from endovascular repair due to unfavorable anatomy. To increase the feasibility of endovascular repair, adjunctive open extra-anatomical bypasses may be required to provide an adequate proximal landing zone. Several methods, for instance, chimney technique, hybrid technique, and fenestrated or branched stent-grafts, have been proposed as options to preserve the supra-aortic branches, each with its own advantages and disadvantages. We herein present a patient with complex anatomical features and blunt aortic injury, who underwent antegrade chimney stent-graft deployment through the ascending aorta, not otherwise amenable to standard retrograde delivery because of severe peripheral artery disease. The remarkable aspect, in this case, is that both stents were placed antegrade, through the ascending aorta.

scholarly journals A ruptured penetrating atherosclerotic ulcer of the ascending aorta: a case report of an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Josephine Chenesseau ◽  
Pierre-Antoine Barral ◽  
Philippe Piquet ◽  
Marine Gaudry
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Endovascular Treatment ◽  
Endovascular Repair ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Stent Grafts ◽  
Penetrating Atherosclerotic Ulcer ◽  
High Risk Patients ◽  
Risk Patients

Abstract Background An endovascular approach to the management of a ruptured plaque in the ascending aorta may be an alternative to open surgery in high-risk patients. This option may become inevitable due to the number of elderly patients unfit for open cardiac surgery. There are very few stent grafts able to fit the ascending aorta and in emergency cases, most medical teams have been limited to current thoracic aortic endografts, the shortest of which measure 10 cm. Case summary We report a case of an endovascular repair of a ruptured penetrating atherosclerotic ulcer of the ascending aorta. The patient was considered for open cardiac surgery but was evaluated at a high mortality risk based on his age, his medical history, and significant calcifications on his aorta. Our vascular surgical team decided then to perform an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery. Discussion Endovascular treatment of an acute ruptured aorta is feasible in high-risk patients with thoracic endovascular stent grafts and coverage of the innominate artery. Endovascular treatment of the ascending aorta is at its infancy and in need of further research. New stent grafts designed for the ascending aorta are in progress and should increase the numbers of interventions in the years to come.

Endovascular Stent Grafts for Acute Blunt Aortic Injury

2004 ◽  
Vol 56 (6) ◽  
pp. 1173-1178 ◽  
Author(s):  
M. B. Dunham ◽  
David Zygun ◽  
P. Petrasek ◽  
John B. Kortbeek ◽  
Riyad Karmy-Jones ◽  
...  
Keyword(s):  
Aortic Injury ◽  
Endovascular Stent ◽  
Stent Grafts ◽  
Blunt Aortic Injury

Endovascular treatment of distal thoracic aortic transection associated with severe thoracolumbar spinal fracture

Vascular ◽  
2014 ◽  
Vol 23 (5) ◽  
pp. 550-552 ◽  
Author(s):  
Megan M Chock ◽  
Johnathon Aho ◽  
Nimesh Naik ◽  
Michelle Clarke ◽  
Stephanie Heller ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Operative Procedure ◽  
Spinal Fracture ◽  
Aortic Injury ◽  
Common Mechanism ◽  
Percutaneous Technique ◽  
Stent Grafts ◽  
Aortic Pseudoaneurysm ◽  
Aortic Transection

Endovascular repair has become the first line of treatment in most patients with blunt aortic injury. The most common mechanism is deceleration injury affecting the aortic isthmus distal to the origin of the left subclavian artery. Injuries of the distal thoracic aorta are uncommon. We report the case of a 25-year-old male patient who presented with paraplegia and distal thoracic aortic pseudoaneurysm associated with severe thoracolumbar vertebral fracture and displacement after a motocross accident. Endovascular repair was performed using total percutaneous technique and conformable C-TAG thoracic stent-graft (WL Gore, Flagstaff, AZ). Following stent-graft placement and angiographic confirmation of absence of endoleak, thoracolumbar spinal fixation was performed in the same operative procedure. This case illustrates a multispecialty approach to complex aortic and vertebral injury and the high conformability of newer thoracic stent-grafts to adapt to tortuous anatomy.

Favorable Outcomes of Open Surgical Repair for Blunt Aortic Injury in the Era of Endovascular Repair

2016 ◽  
Vol 65 (02) ◽  
pp. 105-111
Author(s):  
Min Choi ◽  
Yang Cho ◽  
Wook Kim ◽  
Young Lee ◽  
Dong Jeong ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Surgical Repair ◽  
Aortic Injury ◽  
Open Surgical Repair ◽  
Blunt Aortic Injury

scholarly journals Endovascular repair of blunt aortic injury in a patient with situs inversus and dextrocardia

2011 ◽  
Vol 54 (3) ◽  
pp. 857-859 ◽  
Author(s):  
John F. Bilello ◽  
Peter L. Birnbaum ◽  
Chandra Venugopal ◽  
Leo L. Fong
Keyword(s):  
Endovascular Repair ◽  
Situs Inversus ◽  
Aortic Injury ◽  
Blunt Aortic Injury

Blunt aortic injury: Surgical treatment of the ascending and descending aorta

2021 ◽  
Keyword(s):  
Surgical Treatment ◽  
Surgical Approach ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Aortic Injury ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Blunt Aortic Injury ◽  
Aortic Injuries ◽  
Open Surgical Approach

Traumatic aortic injury is potentially fatal. Although uncommon, involvement of the aortic arch and the ascending aorta can occur. This case shows concomitant dissection of the ascending and descending sections of the aorta after blunt chest trauma where the open surgical approach was successfully performed to treat both aortic injuries.

scholarly journals First Use of GORE TAG Thoracic Endograft with Active Control System in Traumatic Aortic Rupture

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Fotios Eforakopoulos ◽  
Ioanna Akrida ◽  
Petros Zampakis ◽  
Konstantinos Katsanos ◽  
Panagiotis Papadopoulos ◽  
...  
Keyword(s):  
Control System ◽  
Active Control ◽  
Stent Graft ◽  
Motor Vehicle ◽  
Significant Risk ◽  
Aortic Injury ◽  
Landing Zone ◽  
New Device ◽  
Blunt Aortic Injury ◽  
Active Control System

Patients after a high-velocity motor vehicle collision with rapid deceleration are at a significant risk of blunt aortic injury, a life-threatening condition that usually occurs in the aortic isthmus. Aortic transection is the second leading cause of death behind head injury for individuals aged 4 to 34. During the last two decades, there has been a shift from open towards the endovascular repair. Significant progress has been made recently in terms of the design of both the stent graft and the delivery system. We herein present the case of a female patient under dual antiplatelet therapy for coronary artery disease, with type IV blunt aortic injury (rupture) that was successfully repaired with Conformable Thoracic Endograft with Active Control System. This new device provides an intermediate deployment step at 50% and optional angulation control of the proximal part of the stent graft. These improvements are beneficial providing accurate device placement and maximum seal length in anatomies where the distal, as well as a proximal landing zone, is critical.

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