Two-stage hybrid open-endovascular repair of a Crawford type IV aortic aneurysm: therapeutic challenge

Abstract

We present a case of a patient with Crawford type IV aortic thoracoabdominal aneurysm. The patient underwent hybrid repair in two stages. Initially a Dacron  graft was implanted surgically with revascularization of all visceral branches from the left external iliac artery (debranching). On a later date, the second stage of treatment was with an endovascular technique with bi aorto-iliac endoprosthesis. After 2 years the patient remains asymptomatic and in full working activity.Keywords: aortic aneurysm; surgery; aorta; aneurysm. ResumoApresentamos o caso de um paciente com aneurisma aórtico tóraco-abdominal tipo IV de Crawford submetido à correção híbrida em dois estágios. Inicialmente submetido a implante cirúrgico de prótese de Dacron  com revascularização de todos os ramos viscerais a partir da ilíaca externa esquerda (debranching) e, posteriormente, tratado pela técnica endovascular com endoprótese aorto bi-ilíaca. Após dois anos, o paciente permanece assintomático e em plena atividade laborativa.