Thoracic Aortic Stents: a Combined Solution for Complex Cases

• Published in: European journal of vascular and endovascular surgery Vol. 24; no. 5; pp. 423 - 427
• Main Authors: Saccani, S., Nicolini, F., Beghi, C., Marcato, C., Uccelli, M., Larini, P., Budillon, A.M., Agostinelli, A., Gherli, T.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2002
• Subjects: Adult; Aged; Aortic aneurysm, Stent, Vascular surgery; Aortic Aneurysm, Thoracic - surgery; Blood Vessel Prosthesis Implantation - methods; Female; Humans; Male; Middle Aged; Postoperative Complications; Stents; Treatment Outcome; Aortic aneurysm, Stent, Vascular surgery
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1053/ejvs.2002.1687

Objectives: the combination of endovascular and standard surgical techniques may facilitate the management of complex aortic disease although the long-term durability of this approach needs to be confirmed. Design: a retrospective review of our experience in the treatment of patients with complex aortic pathology using a combined endovascular and surgical approach. Materials and methods: between 1998 and 2001, 27 patients with thoracic aortic aneurysm underwent stent-graft implantation. Eight required combined endovascular and surgical procedure because of complex pathology. In 3 cases, combined repair was carried out for a concomitant abdominal aortic aneurysm or aorto-iliac-femoral occlusive disease. In the other 5 cases, vessel relocation was performed to obtain safe landing zones: left subclavian artery to left carotid artery translocation in 3 patients, celiac trunk to superior mesenteric artery translocation in one and aorto-celiac-mesenteric bypass grafting in one. Results: one of the 8 patients died on 12th post-operative day of intestinal bleeding and bowel infarction. No neurological sequelae were reported. The other patients are currently well at 11 months mean follow-up time. Conclusions: simultaneous surgical and endovascular procedure is a feasible and may be a valuable adjunct to the treatment of complex aortic and peripheral vessel anatomy.