Embolization Using a Debranched Left Common Carotid Artery Stump for Gutter Endoleak After Thoracic Endovascular Aortic Repair with the Double-debranching and Chimney Technique

An 88-year-old male underwent thoracic endovascular aortic repair (TEVAR) with the double-debranching and chimney technique for arch aortic aneurysm. When the aforementioned procedure was performed, the left common carotid artery was closed and transected, and the left subclavian artery was embolize...

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Bibliographic Details
Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 76; no. 8; p. 597
Main Authors Kawahara, Yu, Omine, Kaito, Kutsuzawa, Rieko, Otake, Satoshi, Konaka, Miku, Kobayashi, Junichi, Yamashita, Atsushi, Abe, Kazuo, Konno, Masahiko, Araki, Takahiro
Format Journal Article
LanguageJapanese
Published Japan 01.08.2023
Subjects
Aged, 80 and over
Aorta, Thoracic - surgery
Aortic Aneurysm, Thoracic - surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - methods
Endoleak - diagnostic imaging
Endoleak - etiology
Endoleak - surgery
Endovascular Aneurysm Repair
Endovascular Procedures - methods
Humans
Male
Retrospective Studies
Risk Factors
Stents
Treatment Outcome
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Summary:An 88-year-old male underwent thoracic endovascular aortic repair (TEVAR) with the double-debranching and chimney technique for arch aortic aneurysm. When the aforementioned procedure was performed, the left common carotid artery was closed and transected, and the left subclavian artery was embolized and bypassed, respectively. However, postoperatively, the gutter endoleak persisted, and the aneurysm enlarged;therefore, requiring additional surgery. A skin incision was made on the left side of the neck, and the closed and dissected left common carotid artery stump was detected. A sheath was placed at the stump and an angiographic catheter and guidewire were used to retrograde cannulate the gutter beside the chimney graft, and coil embolization was performed. No endoleak was observed at postoperatively and 6-month follow up computed tomography( CT). We believe that embolization from a deblanched left common carotid artery stump is useful for endoleaks after TEVAR employing the chimney and debranching technique.
ISSN:0021-5252