Aneurysmal dilation of the reimplant segment of the visceral vessels after thoracoabdominal aneurysm correction

Abstract

We present a case of aneurysmal dilation of the aortic residual segment, involving abdominal vessels in corrective surgeries for thoracoabdominal aortic aneurysm, through the identification of risk groups for recurrent dilation, aiming at using a specific operative technique with a branched graft, to prevent aneurysm relapse.

Patency and durability of presewn multiple branched graft for thoracoabdominal aortic aneurysm repair

“…Over time, the potential exists for this tissue to become aneurysmal or separate from the graft, with the risk of subsequent rupture. 2,3 Previous studies have suggested that the prevalence of visceral artery patch aneurysms after TAAA repair using the Crawford or Carrel techniques is between 4% and 8%. 2,4,5 We previously applied the Carrel patch technique during TAAA repair.…”

Thoracoabdominal aneurysm repair using a four-branched thoracoabdominal graft: a case series

“…Using the traditional Crawford technique for thoracoabdominal aneurysm repair, the reported incidence of patch aneurysm formation can be as high as 7.5% and can be higher (17%) in Marfan patients [2,3,5,8]. Reoperation is technically demanding due to adhesions in approaching the patch.…”

“…Although this approach can reduce operative time, it is not optimal for young patients with connective tissue disease, or those whose residual aortic segment is extensive (due to the distance between vessels), as the residual aortic segment is more prone to dilatation, aneurysm formation and potential rupture during the follow-up period. [5,6]. To address these concerns, a specifically designed multi-branched thoracoabdominal graft has been introduced (Gelweave® Coselli Thoracoabdominal Graft, Vascuteck-Terumo, Renfrewshire Scotland, UK, Figure 1a), originally stemming from a multi-branched transverse aortic arch substitution, [7] with appropriately sized and positioned branches for the celiac, superior mesenteric and both renal arteries.…”

Recurrent Thoracoabdominal Aortic Aneurysm with Visceral Artery Involvement: Treatment Options

“…The experience on visceral aortic patch aneurysm management published in the literature highlights morbidity and mortality rates unfavorable with both redo-open TAAA repair and with hybrid approach [2,3,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. These results are the rationale for an attempt of total endovascular repair [22].…”