Mesenteric PTA is a valuable treatment option in patients who have CMI and are considered very high operative risks. The initial technical success rate is excellent, with the majority of patients having complete symptomatic improvement and continued relief of symptoms at short-term follow-up.

Aneurysms involving the suprarenal, visceral, and lower thoracic aorta may be repaired with acceptable perioperative mortality and late survival rates. The risk of spinal cord ischemia is increased for patients with aortic dissection and may be stratified according to the proximal extent of the aneurysm.

Our data show that there is a high incidence of smoking and symptomatic presentation among young patients in whom carotid occlusive disease develops. CEA may be performed in young patients with low perioperative morbidity and mortality rates. Recurrent disease, late stroke, and survival rates are not significantly different than for older patients. Follow-up with serial duplex ultrasound and reoperation for symptomatic and high-grade asymptomatic restenosis may decrease the risk of late stroke.

No abstract

a filter to trap the debris before re-infusing the blood. The use of AngioVac in the treatment of thrombus in the arterial system has yet to be described. We present the first case report of successful treatment of symptomatic thoracoabdominal mural and floating intra-aortic thrombus using a thoracic endograft (C-TAG; W. L. Gore and Associates, Flagstaff, Ariz) in conjunction with the AngioVac device.Objectives: A 46-year-old female presented with primary aortic mural thrombus beginning mid descending aorta with extension distally into the celiac artery and evidence of visceral embolization demonstrated on computed tomography angiography (CTA) (Fig 1). The patient was taken to the angiography suite for exclusion of the aortic thrombus with an endograft in conjunction with percutaneous celiac thrombectomy.Methods: Follow-up CTA revealed thrombus extending from beneath the distal landing zone of the endograft into the abdominal aorta which appeared to be floating in the visceral segment.The patient was brought back to the angiography suite for AngioVac thrombectomy. Bilateral femoral cutdowns were performed and the Angiovac device was placed through the iliofemoral arterial system into the abdominal aorta with the return venous cannula placed in the contralateral femoral vein.Results: Successful extraction of the thrombus was achieved and confirmed on follow-up CTA imaging (Fig 2).Conclusions: This case demonstrates the effective utilization of an endograft and AngioVac thrombectomy as an effective treatment option for select patients with symptomatic primary thoracoabdominal aortic mural thrombus. Ease of use and low risk profile suggests this technique could become a front line option for select patients. Long-term follow-up will be necessary to assess durability of this technique .