A challenging double bubble thoracic aortic and proximal subclavian aneurysm treated via transapical access

Beaufort, Hector W. de; Heuvel, Daniel A. van den; Heijmen, Robin H.

doi:10.1016/j.jvscit.2019.07.009

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…The feasibility of thoracic stent-graft insertion and deployment, using transaxillary, transcarotid, or even transapical access, has been previously demonstrated in patients with aorto-iliac occlusion or severe atherosclerotic disease. [9][10][11] Chimney procedures have also been reported in patients with juxtarenal aortic occlusion, with favorable results. 12,13 Thus, in case of unavailability of custom-made devices, other approaches are theoretically feasible; however, they would have required a bilateral upper extremity access with the use of simultaneous sheaths thus increasing the risk of stroke due to excessive arch endo-manipulation.…”

Section: Discussionmentioning

confidence: 99%

Transaxillary Tri-Branch Aortic Endovascular Graft Repair of Recurrent Thoracoabdominal Aneurysm With Pararenal Aortic Occlusion

et al. 2022

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The absence of an adequate ileo-femoral access is usually considered an absolute contraindication to fenestrated and branched aortic repairs. Alternative routes and dedicated stent-graft designs have been advocated. Hereby, we describe the case of a 73-year-old man with a recurrent type IV thoracoabdominal aortic aneurysm and complete thrombotic pararenal aortic occlusion treated successfully with a tri-branch custom-made endograft deployed via a transaxillary access.

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Section: Discussionmentioning

confidence: 99%

Transaxillary Tri-Branch Aortic Endovascular Graft Repair of Recurrent Thoracoabdominal Aneurysm With Pararenal Aortic Occlusion

et al. 2022

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Multicentre experience of antegrade thoracic endovascular aortic repair for the treatment of thoracic aortic diseases

Gibello,

Antonello,

Civilini

et al. 2024

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Aim of this multicentre retrospective cohort study is to evaluate technical success, early and late outcomes of thoracic endovascular repair (TEVAR) with grafts deployed upside-down through antegrade access, to treat thoracic aortic diseases. METHODS Antegrade TEVAR performed between January 2010 and December 2021 have been collected and analyzed. Both elective and urgent procedures were included. Exclusion criteria were endografts deployed into previous or concomitant surgical or endovascular repairs. RESULTS Fourteen patients were enrolled; 13 males (94%) with mean age of 71 years (IQR 62; 78). Five patients underwent urgent procedures (2 ruptured aortas and 3 symptomatic patients). Indication to treatment were 8 (57%) aneurysms/pseudoaneurysms, 3 (21%) dissections and 3 (21%) penetrating aortic ulcers. Technical success was achieved in all procedures. Early mortality occurred in 4 (28%) cases, all urgent procedures. Median follow-up was 13 months (IQR 1; 44). Late death occurred in 2 (20%) patients, both operated in elective setting. The first died at 19 months due to aortic-related reintervention, the second died at 34 months for a not aortic-related cause. Two patients (14%) underwent aortic-related reintervention for late type I endoleak. Survival rate in elective procedures was 100%, 84% and 67% at 12, 24 and 36 months respectively. Freedom from reintervention was 92%, 56% and 56% at 12, 24 and 36 months respectively. CONCLUSIONS Antegrade TEVAR can seldomly be considered an alternative when traditional retrograde approach is not feasible. Despite good technical success and low access-site complications, this study demonstrates high rates of late type I endoleak and aortic-related reinterventions.

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A challenging double bubble thoracic aortic and proximal subclavian aneurysm treated via transapical access

Cited by 2 publications

References 11 publications

Transaxillary Tri-Branch Aortic Endovascular Graft Repair of Recurrent Thoracoabdominal Aneurysm With Pararenal Aortic Occlusion

Transaxillary Tri-Branch Aortic Endovascular Graft Repair of Recurrent Thoracoabdominal Aneurysm With Pararenal Aortic Occlusion

Multicentre experience of antegrade thoracic endovascular aortic repair for the treatment of thoracic aortic diseases

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