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European Radiology

, Volume 20, Issue 4, pp 1011–1022 | Cite as

Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know

  • Tobias Krauss
  • Thomas Pfammatter
  • Dieter Mayer
  • Mario Lachat
  • Lukas Hechelhammer
  • Borut Marincek
  • Thomas Frauenfelder
Vascular-Interventional

Abstract

Purpose

Endovascular aneurysm repair of the infrarenal or thoracic aorta has been shown to be a less invasive alternative to open surgery. A combined aneurysm of the thoracic and abdominal aorta is complex and challenging; the involvement of renal and/or visceral branches requires new treatment methods.

Methods

A hybrid approach is currently an accepted alternative to conventional surgery. Renal and/or visceral revascularisation enables subsequent stent-graft placement into the visceral portion of the aorta.

Results

Knowledge of the surgical procedure and a precise assessment of the vascular morphology are crucial for pre-procedural planning and for detection of post-procedural complications. Multi-detector computed tomography angiography (MDCTA) combined with two- and three-dimensional (2D and 3D) rendering is useful for pre-interventional planning and for the detection of post-procedural complications. Three-dimensional rendering allows proper anatomical analyses, influencing interventional strategies and resulting in a better outcome.

Conclusions

With the knowledge of procedure-specific MDCTA findings in various vascular conditions, the radiologist and surgeon are able to perform an efficient pre-interventional planning and follow-up examination. Based on our experience with this novel technique of combined open and endovascular aortic aneurysm treatment, this pictorial review illustrates procedure-specific imaging findings, including common and rare complications, with respect to 2D and 3D post-processing techniques.

Keywords

Endovascular repair Hybrid repair Thoraco-abdominal aortic aneurysm Debranching 

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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Tobias Krauss
    • 1
  • Thomas Pfammatter
    • 1
  • Dieter Mayer
    • 2
  • Mario Lachat
    • 2
  • Lukas Hechelhammer
    • 1
  • Borut Marincek
    • 1
  • Thomas Frauenfelder
    • 1
  1. 1.Department of Medical Radiology, Institute of Diagnostic RadiologyUniversity Hospital ZurichZurichSwitzerland
  2. 2.Clinic for Cardiovascular SurgeryUniversity Hospital of ZurichZurichSwitzerland

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