Images at the time of admission after additional endovascular repair (details above) show exclusion of endoleak of the descending aorta. There is no partial flow in the false lumen of the ascending aorta

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 341-341
Author(s):  
Paul Schoenhagen
Keyword(s):  
Endovascular Repair ◽  
False Lumen ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Time Of Admission

Avoiding Arch Manipulation with Catheterization of Left Subclavian Artery for Endovascular Repair of Distal Descending Aorta: Acibadem Technique

2020 ◽  
Vol 15 (2) ◽  
pp. 163-165
Author(s):  
Sahin Senay ◽  
Serdar Akansel ◽  
Ahmet Ümit Güllü ◽  
Cem Alhan
Keyword(s):  
Subclavian Artery ◽  
Endovascular Repair ◽  
Open Surgery ◽  
Stroke Risk ◽  
Left Subclavian Artery ◽  
Ascending Aorta ◽  
Thoracic Endovascular Aortic Repair ◽  
Descending Aorta ◽  
Aortic Repair ◽  
A New Technique

Although thoracic endovascular aortic repair (TEVAR) is associated with reduced mortality and shorter hospital stay compared to open surgery, the decrease in stroke risk did not reach the desired rates. Aortic arch manipulation is one of the main concerns leading to stroke during TEVAR. Here, we describe a new technique called “Acibadem Technique” to avoid arch and ascending aorta manipulation with catheterization of left subclavian artery for endovascular distal descending aortic repair.

scholarly journals Time-Resolved Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography in Patients with Chronic Expanding and Stable Aortic Dissections

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Michael Trojan ◽  
Fabian Rengier ◽  
Drosos Kotelis ◽  
Matthias Müller-Eschner ◽  
Sasan Partovi ◽  
...  
Keyword(s):  
Three Dimensional ◽  
False Lumen ◽  
Ascending Aorta ◽  
Stable Group ◽  
Time Resolved ◽  
Descending Aorta ◽  
Peak Intensity ◽  
Contrast Enhanced ◽  
Aortic Dissections

Objective. To prospectively evaluate our hypothesis that three-dimensional time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) is able to detect hemodynamic alterations in patients with chronic expanding aortic dissection compared to stable aortic dissections. Materials and Methods. 20 patients with chronic or residual aortic dissection in the descending aorta and patent false lumen underwent TR-MRA of the aorta at 1.5 T and repeated follow-up imaging (mean follow-up 5.4 years). 7 patients showed chronic aortic expansion and 13 patients had stable aortic diameters. Regions of interest were placed in the nondissected ascending aorta and the false lumen of the descending aorta at the level of the diaphragm (FL-diaphragm level) resulting in respective time-intensity curves. Results. For the FL-diaphragm level, time-to-peak intensity and full width at half maximum were significantly shorter in the expansion group compared to the stable group (p=0.027 and p=0.003), and upward and downward slopes of time-intensity curves were significantly steeper (p=0.015 and p=0.005). The delay of peak intensity in the FL-diaphragm level compared to the nondissected ascending aorta was significantly shorter in the expansion group compared to the stable group (p=0.01). Conclusions. 3D TR-MRA detects significant alterations of hemodynamics within the patent false lumen of chronic expanding aortic dissections compared to stable aortic dissections.

Application of an extracorporeal prefenestrated stent graft in endovascular repair of ascending aorta and aortic arch lesions

Vascular ◽  
2020 ◽  
pp. 170853812095087
Author(s):  
Liang Wang ◽  
Lei Bai ◽  
Yujing Zhang ◽  
Jianglong Liu ◽  
Xiaodong Li
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Endovascular Repair ◽  
Spinal Cord Ischemia ◽  
False Lumen ◽  
Ascending Aorta ◽  
Type I ◽  
Stent Grafting ◽  
Surgical Methods ◽  
Type I Endoleak

Objectives Aortic dissection involving the ascending aorta and aortic arch is a serious condition. Treatment using traditional surgical methods has certain disadvantages. This study investigated the effectiveness of thoracic endovascular repair of aortic dissection using an external prefenestrated stent. Methods We present a series of aortic dissection cases involving the ascending aorta and aortic arch treated with an external prefenestrated stent. Results Postoperative follow-up of the patients showed that all stents were released at the proper position and that branch vessels were not occluded, and there were no instances of type I endoleak. One patient died suddenly one week after surgery; another experienced retrograde type A aortic dissection in the second week; and type I endoleak occurred in one patient in the first week, although this resolved within six months. No serious complications such as cerebrovascular events, acute spinal cord ischemia, and paraplegia occurred during the perioperative period. All patients had false lumen thrombosis in the ascending aorta and aortic arch. Conclusion Prefenestrated stent grafting is a feasible treatment option for repairing an entry tear in the ascending aorta.

scholarly journals Modified Port-Access Technique for the Treatment of Aortic Dissection after Previous Cardiac Surgery

2017 ◽  
Vol 44 (3) ◽  
pp. 202-204
Author(s):  
Edvin Prifti ◽  
Aurel Demiraj ◽  
Roland Xhaxho
Keyword(s):  
Cardiac Surgery ◽  
Aortic Dissection ◽  
Myocardial Protection ◽  
Circulatory Arrest ◽  
False Lumen ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation ◽  
Port Access

One of the most challenging conditions to manage after previous cardiac surgery is chronic dissection of the ascending aorta. We operated on a 54-year-old man who had aortic dissection in addition to large aortic dimensions very close to the sternum, severe aortic regurgitation, and a false lumen in the descending aorta. We used a combination of perfusion and myocardial protection techniques, arising from port-access technology, that enabled antegrade flow into the aorta, endoclamping of the ascending aorta, the administration of cardioplegic solution before opening the sternum, and left ventricular venting to prevent ventricular distention. Our technique resulted in minimal blood loss, shorter circulatory-arrest and operative times, the ability to operate on a decompressed heart and descending aorta, good myocardial protection, and easier and safer access to the heart. Three years postoperatively, our patient was doing well. Other patients might benefit from this approach; however, the surgeon must ensure that an aortic segment is suitable for endoclamping.

scholarly journals Candy-plug technique for ruptured chronic type B aortic dissection

2019 ◽  
Vol 27 (9) ◽  
pp. 770-772
Author(s):  
Akimasa Morisaki ◽  
Etsuji Sohgawa ◽  
Noriaki Kishimoto ◽  
Kokoro Yamane ◽  
Toshihiko Shibata
Keyword(s):  
Computed Tomography ◽  
Aortic Dissection ◽  
Endovascular Repair ◽  
Computed Tomography Angiography ◽  
False Lumen ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Descending Aorta ◽  
Mediastinal Hematoma

Ruptured chronic type B aortic dissection is conventionally repaired surgically; however, the mortality is high. We report successful use of the candy-plug technique for ruptured chronic type B aortic dissection. A 62-year-old man with ruptured type IIIb dissection was transferred to our hospital as an emergency. Computed tomography angiography showed a dissecting aorta with a patent false lumen, ruptured proximal descending aorta, distal aortic arch entry, and mediastinal hematoma. Debranching endovascular repair with the candy-plug technique achieved occlusion of the false lumen of the ruptured aortic dissection. The patient recovered uneventfully and the false lumen gradually decreased with no endoleak.

Type A Intramural Hematoma Often Turns Out To Be a Type A Dissection

2013 ◽  
Vol 16 (6) ◽  
pp. 351 ◽  
Author(s):  
Sebastian Michel ◽  
Christian Hagl ◽  
Gerd Juchem ◽  
Ralf Sodian
Keyword(s):  
Computed Tomography ◽  
Surgical Repair ◽  
False Lumen ◽  
Intramural Hematoma ◽  
Acute Chest Pain ◽  
Type A ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Type A Dissection ◽  
Thrombosed Type

<p><b>Background:</b> The management of type A intramural hematoma (IMH) is controversial. Although most Western countries still recommend immediate surgical repair, some centers in Asia have shown good results recently with medical treatment alone. Here, we present a case of type A IMH which was discovered during the operation to be a thrombosed type A dissection.</p><p><b>Case Report:</b> An 83-year-old female patient presented with acute chest pain. After diagnostic exclusion of myocardial infarction, computed tomography was performed, which showed an IMH from the ascending to the descending aorta. No intimal flap could be detected. The ascending aorta was replaced surgically with a prosthesis. During the operation, we found a ruptured intimal plaque, which had caused dissection of the aorta with thrombosis of the false lumen. The true diagnosis�thrombosed type A dissection and not IMH�was revealed neither by computed tomography nor by transesophageal echocardiography.</p><p><b>Conclusion:</b> Type A IMH should still be treated with immediate surgical repair because in many cases it turns out to be thrombosed type A dissection.</p>

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