Balloon-expandable stent graft for coral reef aorta

Abstract

Coral reef aorta (CRA) is a rare aortic occlusive disease with calcified intraluminal lesions. We report the case of a patient with CRA who underwent endovascular treatment (EVT). A 78-year-old woman presented with intermittent claudication. A computed tomography scan showed a preocclusive calcified lesion in the infrarenal aorta. EVT with a balloon-expandable stent graft was successfully performed, and her intermittent claudication improved. Compared with the conventional surgical treatments for CRA, EVT with a balloon-expandable stent graft is less invasive. This procedure is an effective option for the treatment of CRA.

Challenging Endovascular Treatment of Coral Reef Aorta and a Literature Review

“…7 In the last decade, the endovascular method seems to make its appearance and is the protagonist in the treatment of selected patients with CRA who cannot be treated with the open method. According to the current literature and platforms, the terms “endovascular stent-graft therapy” and “coral reef aorta” coexist and appear since 2008, and since then, only 13 articles ( Table 1 ) 3 4 5 8 10 11 12 13 14 15 16 17 18 have been published, most of them in the past 3 years. This is probably because vascular surgeons' familiarity with the endovascular technique and the appearance of newer and more advanced endovascular tools encourage vascular surgeons to dare to use the method.…”

“…The risk of aorta rupture is always present, which a dangerous scenario in endovascular treatment; therefore, the vascular surgeon must be prepared for its treatment by controlling bleeding with intra-aortic balloon occlusion and then selecting a stent graft or open surgery, depending on the extent and location of bleeding. 15…”

“…The risk of aorta rupture is always present, which a dangerous scenario in endovascular treatment; therefore, the vascular surgeon must be prepared for its treatment by controlling bleeding with intra-aortic balloon occlusion and then selecting a stent graft or open surgery, depending on the extent and location of bleeding. 15 Another complication that can occur is the fracture of the stent graft, due to the intensely calcified aorta, but this is restricted by the correct choice of graft size.…”

“…Recorded cases of endovascular treatment with stent graft of coral reef aorta reported in bibliographic databases and platforms[3][4][5]8,[10][11][12][13][14][15][16][17][18] …”

The Use of a Commercially Available Endovascular Filter Catheter (Capturex®) for Thoracic Endovascular Aortic Repair (TEVAR) in a Patient with a Coral Reef Aorta

“…Further, a balloon-expandable 16/59 mm BeGraft ® aortic stent graft (Bentley InnoMed GmbH, Hechingen, Germany) was introduced via the ipsilateral 11-French sheath and deployed at the obstructive coral reef aortic segment (Fig. 2 B) [ 4 ]. Thus, having created a safe working channel, a 32/164 mm Relay ® PRO thoracic stent graft (Bolton Medical, Inc., Sunrise, Fl, U.S.A.) was introduced via the right common femoral artery and deployed over the aneurysm.…”