Background: An aneurysm is a focal dilatation of the artery, attaining a diameter of at least 150% of that expected for this segment. The aortic aneurysm is the 13th leading cause of death in the United States and the third cause of sudden death. The endovascular treatment for aneurysm is based on the exclusion of the aneurysm by implanting a prosthesis comprising a metal frame similar to a stent, but coated by a synthetic fabric, the so-called endoprosthesis. In this case report, we present the repair of a thoracoabdominal aortic aneurysm diagnosed in the investigation for hepatic hemangioma.
Methods: Surgical planning was based on the use of a branched prosthesis to the celiac trunk and fenestrated to the superior mesenteric artery and renal arteries. The surgical team decided to do the revascularization of the left subclavian artery, which would have its ostium covered by an endoprosthesis to maintain pulsatile flow through the left vertebral artery and left internal thoracic, which aid in collateral circulation to the spinal cord through a left subclavian carotid bridge.
Results: Angiotomographic control after 3 months of the surgery showed complete exclusion of the aneurysm and discreet decrease in its maximum transverse diameter (5.6 cm) beyond the patency of all visceral trunks and carotid-subclavian left bridge.
Conclusion: This case report presents a successful endovascular treatment of a thoracoabdominal aortic aneurysm. Despite the increasingly space reserved for endovascular surgery in daily medical practice, we should not neglect the training of surgeons of future generations in the skills of the open operation, so that the domain of both techniques makes the surgeon able to choose and execute the best option considering the particularities of each case.
- 2.Reilly LM, Chuter TA. Endovascular repair of thoracoabdominal aneurysms: design options, device construct, patient selection and complications. J Cardiovasc Surg. 2009;50(4):447–60.Google Scholar
- 4.Verhoeven EL, Tielliu IF, Ferreira M, Zipfel B, Adam DJ. Thoraco- abdominal aortic aneurysm branched repair.J. Cardiovasc Surg (Torino). 2010;51(2):149–55.Google Scholar