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

  • Vascular-Interventional
  • Published:
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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.

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Authors and Affiliations

  1. Department of Medical Radiology, Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Tobias Krauss, Thomas Pfammatter, Lukas Hechelhammer, Borut Marincek & Thomas Frauenfelder

  2. Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland

    Dieter Mayer & Mario Lachat

Authors
  1. Tobias Krauss
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  2. Thomas Pfammatter
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  3. Dieter Mayer
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  4. Mario Lachat
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  5. Lukas Hechelhammer
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  6. Borut Marincek
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  7. Thomas Frauenfelder
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Correspondence to Thomas Frauenfelder.

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Krauss, T., Pfammatter, T., Mayer, D. et al. Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know. Eur Radiol 20, 1011–1022 (2010). https://doi.org/10.1007/s00330-009-1603-3

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  • DOI: https://doi.org/10.1007/s00330-009-1603-3

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