Transrenal E-XL stenting prior to EVAR in the case of abdominal aortic aneurysm associated to proximal aortic neck dissection

Chronic dissection of proximal aortic neck is a rare occurrence in patients with abdominal aortic aneurysm (AAA) and a gold standard therapy has not been defined so far. Herein we report two successful cases of an original adjunctive procedure involving the transrenal placement of a self-expanding n...

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Bibliographic Details
Published inJournal of cardiovascular surgery Vol. 55; no. 6; p. 827
Main Authors Ventoruzzo, G, Chisci, E, Croce, S, Turini, F, Michelagnoli, S, Bellandi, G
Format Journal Article
LanguageEnglish
Published Italy 01.12.2014
Subjects
Aged
Aged, 80 and over
Alloys
Aneurysm, Dissecting - diagnosis
Aneurysm, Dissecting - surgery
Aortic Aneurysm, Abdominal - diagnosis
Aortic Aneurysm, Abdominal - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Endovascular Procedures - instrumentation
Humans
Male
Prosthesis Design
Stents
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Chronic dissection of proximal aortic neck is a rare occurrence in patients with abdominal aortic aneurysm (AAA) and a gold standard therapy has not been defined so far. Herein we report two successful cases of an original adjunctive procedure involving the transrenal placement of a self-expanding nitinol stent (E-XL aortic stent, Jotec GmbH, Germany) in order to fix a dissection flap in the aortic neck wall prior to the deployment of the bifurcated endograft. Primary technical success and midterm clinical success was achieved in both cases with freedom from any early or late reintervention. Scheduled follow-up angio-CT scans did not show any Type I endoleak, graft migration or renal/visceral arteries complications. According to these findings, patients with an AAA, presenting with a proximal neck with chronic dissection, can be safely and effectively treated by pre-emptive transrenal E-XL stenting and endovascular aneurysm repair.
ISSN:1827-191X