Initial Experience in the Treatment of Thoracic Aortic Aneurysmal Disease with a Thoracic Aortic Endograft at Baylor University Medical Center

Abstract

A retrospective review of 27 patients who underwent endovascular repair of thoracic aneurysms and of other thoracic aortic pathology with the thoracic aortic endograft (Gore Medical, Flagstaff, AZ) from June 2005 to July 2007 was performed. The mean follow-up period was 13.5 months (range, 2-25 months). Indications for thoracic endografting included descending thoracic aneurysms (n = 18), thoracoabdominal aneurysms (n = 3), traumatic aortic injuries (n = 3), penetrating aortic ulcers (n = 2), and contained rupture of a type B dissection (n = 1). One patient died during the procedure, for an overall mortality rate of 3.7%. The average length of stay was 8.1 days, with an average stay in the intensive care unit of 4.2 days. If patients with traumatic aortic injuries were excluded, the average overall and intensive care unit length of stay were 5.6 and 1.8 days, respectively. There was one incident of spinal cord ischemia (3.7%). There were five type I or type III endoleaks, three of which required revision (11.1%). In conclusion, thoracic endografting is a safe and viable option for the repair of descending thoracic aneurysms and other aortic pathologies. We have found it to be less invasive, even in conjunction with preoperative debranching procedures, with a shorter recovery time, decreased perioperative morbidity and blood loss, and decreased peri-operative mortality compared with standard open repair.

Fully percutaneous treatment of an aberrant right subclavian artery and thoracic aortic aneurysm

“…14 Left carotid-subclavian artery bypasses along with a TAG endoprosthesis have also been reported. 15 For our case, we wished to avoid open surgery given the patient's advanced age and comorbidities and felt that a percutaneous option with a fenestrated graft in conjunction with covered stents for side branch preservation would allow successful aneurysm exclusion.…”

A technique for a single-stage off-pump repair of Kommerell diverticulum with antegrade branch vessel reconstruction

“… 1 Reported endovascular repair was either purely endovascular with coverage of both subclavian arteries without revascularization at all or with various configurations of bypasses or transpositions in the neck, most commonly bilateral carotid–subclavian bypasses. 2 , 3 , 4 , 5 …”

Hybrid Treatment in a Patient With Acute Aortic Syndrome and an Aberrant Right Subclavian Artery

“…The aberrant right subclavian artery (ARSA), also known as the lusorian artery, is a major abnormality of thoracic arteries; it is encountered in 0.4% to 2% of patients. 1 The majority of patients are asymptomatic. However, when the ARSA turns into an aneurysm, patients experience dysphagia, shortness of breath, or chest pain.…”