Therapeutic Strategies for Infectious Multiple Aortic Aneurysms: Thoracoabdominal Aortic Aneurysm Treatment Using a Fenestrated Stent-Graft

• Published in: Annals of Vascular Diseases Vol. 13; no. 3; pp. 326 - 329
• Main Authors: Okugi, Satoshi, Azuma, Takashi, Yokoi, Yoshihiko, Domoto, Satoru, Niinami, Hiroshi
• Format: Journal Article
• Language: English
• Published: Japan The Editorial Committee of Annals of Vascular Diseases 25.09.2020; Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology
• Subjects: aorta; Case Report; endovascular surgery; stent graft; thoracoabdominal aortic aneurysm; case report; aorta; thoracoabdominal aortic aneurysm; endovascular surgery; stent graft
• ISSN: 1881-641X; 1881-6428
• DOI: 10.3400/avd.cr.20-00032

Recently, it has been reported that a fenestrated stent graft is an effective option in the treatment of pararenal artery abdominal aortic aneurysm. We report the case of a 72-year-old male patient with multiple aortic aneurysms in the distal arch, thoracoabdominal aorta, right common iliac artery, as well as a pararenal abdominal aortic aneurysm. The patient was found to have a mass with a tendency of rapid expansion within a month from its discovery. Because it was a saccular aneurysm with a tendency of rapid expansion and wide spread, the risk of rupture was judged to be high, and surgical treatment became necessary. One-stage treatment was desirable; therefore, endovascular treatment with a fenestrated stent graft was selected. Four fenestrations were made to a stent graft for the celiac artery, superior mesenteric artery, and bilateral renal arteries. The postoperative computed tomography (CT) showed no branch occlusion or endoleak, and the 2-year postoperative CT showed the shrinkage and subsequent disappearance of the aortic aneurysm at the treatment site. For extensive aortic aneurysm, including pararenal artery abdominal aortic aneurysms, one-stage treatment with fenestrated stent graft was considered to be effective as a treatment strategy. (This is a translation of Jpn J Vasc Surg 2020; 29: 9–13.)