Thoracic endovascular aortic repair in patients with unfavorable anatomy (case report)

DOI: https://doi.org/10.25512/DIR.2017.11.2.10

For quoting:
Idrisov I.A., Khafizov T.N., Nikolaeva I.E., Imaev T.E., Izhbuldin R.I., Khafizov R.R., Temirova L.V., Oleynik B.A. "Thoracic endovascular aortic repair in patients with unfavorable anatomy (case report)". Journal Diagnostic & interventional radiology. 2017; 11(2); 81-87.

authors:

Idrisov I.A.

Khafizov T.N.

Nikolaeva I.E.

Imaev T.E.

Izhbuldin R.I.

Khafizov R.R.

Temirova L.V.

Oleynik B.A.

keywords:

aortic arch rupture

stent-graft

unfavorable thoracic aorta anatomy

Thoracic Endovascular Aortic Repair

«chimney» technique

Abstract:

Endovascular treatment of thoracic aortic dissection type B is the method of choice in complicated cases. These interventions are obviously less traumatic, accompanied by less blood loss, shorten the length of stay in the intensive care unit, and there is a smaller number of complications. Successful treatment requires careful planning and determination of the existence of conditions for the implantation of endovascular prostheses. It is important to analyze the question of vascular approach, the availability of landing zone, the feasibility of switching aorta branches before implantation etc. However, you can have experience of not predicted of intraoperative complications.

Article presents two clinical cases of implantation of stent-grafts in patients with challenging anatomy of the defeat of the thoracic aorta. In both cases, we used hybrid approach. In each case we used carotid-subclavian shunting before implantation of the stent-graft and in one case we usee «chimney» technique. Thoracic Endovascular Aortic Repair in these patients was accompanied by certain difficulties. Anatomical difficulties were overcome by using of not standart technique during operation.

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