Hybrid Debranching-Endovascular Repair of Visceral Patch Aneurysm After Thoracoabdominal Aneurysm Repair

Abstract

A visceral patch aneurysm is a significant complication after extensive thoracoabdominal aneurysm repair, and open procedures to correct these lesions are associated with a high perioperative mortality. We report the case of a 6-cm visceral patch aneurysm occurring in a patient with a completely replaced descending and abdominal aorta that was successfully corrected by staged debranching and endovascular repair with a dedicated thoracic endograft. Hybrid procedures are a successful option to treat complex repairs in the reoperative setting. They have the potential to lower perioperative risk and enhance patient care.

Management of visceral aortic patch aneurysms after thoracoabdominal repair with open, hybrid, or endovascular approach

“…32 The experience on management of VAP aneurysm published in the literature highlights unfavorable morbidity and mortality rates both with redo open TAAA repair and with the hybrid approach (Table V). 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 of VAP aneurysms. The first endovascular treatment of a VAP aneurysm was reported in 2007 by Adam et al 22 with a fenestrated custom-made device.…”

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].…”

Renal Autotransplantation as Savior in Hybrid Surgery for Aortic Aneurysm Repair

“…Visceral artery revascularization is necessary in cases where visceral arteries arise from the aneurysmal sac. The primary association of surgical and interventional radiological procedures is called ‘combined or hybrid strategy’ [8]. This technique is advantageous in being haemodynamically less stressful and in non-clamping AAA repair.…”