Hybrid Approach to Complex Arch and Thoracoabdominal Aneurysms in a Case of High-Risk Patient

Ohta H, Ohki T, Kanaoka Y, Kurosawa K, Fukushima S and ToyaN

Division of Vascular Surgery, Department of Surgery, Jikei University Graduate School of Medicine, Japan
Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Japan
Division of Vascular Surgery, Department of Surgery, Jikei University Kashiwa Hospital, Japan

^*Correspondance to: Hiroki Ohta 

 PDF  Full Text DOI: 10.25107/2474-1647.1011

Abstract

Endovascular therapy is a less invasive alternative treatment with aortic aneurysm. However in patients with multiple aneurysms, the surgical procedures orders of operating are controversial. The present report describes the case of a 65-year-old man with aneurysms in which the aortic arch (Zone 1) and the thoracoabdominal aorta (Crawford extent IV) presented challenge for complex aortic morphology. The patient had diagnosed as being inoperable at other university hospitals, because of a marked decrease of cardiopulmonary function. Therefore we preformed two-stage stent graft operations. Endovascular repair was achieved using additional common carotid artery (CCA) to CCA bypass into the aortic arch, and using fenestrated and branched stent graft into the visceral aortic segment. Before secondary operation, the patient had a contained rupture of the TAAA. His postoperative course was uneventful. The hybrid approach of surgical debranching and endovascular stent grafting for high-risk patients makes it possible to obtain a chance for effectively treating the multiple aneurysms.

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Cite the article

Ohta H,Ohki T, Kanaoka Y, Kurosawa K, Fukushima S, ToyaN. Hybrid Approach to Complex Arch and Thoracoabdominal Aneurysms in a Case of High-Risk Patient. Clin Surg. 2016; 1: 1011.