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Recurrent Thoracoabdominal Aortic Aneurysm with Visceral Artery Involvement: Treatment Options

  • Luca BertoglioEmail author
  • Alessandro Grandi
  • Tommaso Cambiaghi
  • Andrea Melloni
  • Simone Salvati
Chapter

Abstract

Revascularization of splanchnic and renal arteries is one of the critical steps in open repair of thoracoabdominal aortic aneurysm (TAAA). Several techniques are currently employed, but the most represented is the inclusion technique proposed by Stanley Crawford in the early 1970s: it consists in a side-to-end anastomosis aimed at reimplanting, on a side opening in the synthetic Dacron graft, an island of aortic wall from which the visceral arteries arise [1].

References

  1. 1.
    Crawford ES. Thoraco-abdominal and abdominal aortic aneurysms involving renal, superior mesenteric, celiac arteries. Ann Surg. 1974;179:763–72.CrossRefGoogle Scholar
  2. 2.
    Dardik A, Perler BA, Roseborough GS, Williams GM. Aneurysmal expansion of the visceral patch after thoracoabdominal aortic replacement: an argument for limiting patch size? J Vasc Surg. 2001;34:405–9.CrossRefGoogle Scholar
  3. 3.
    Tshomba Y, Melissano G, Civilini E, Setacci F, Chiesa R. Fate of the visceral aortic patch after thoracoabdominal aortic repair. Eur J Vasc Endovasc Surg. 2005;29:383–9.CrossRefGoogle Scholar
  4. 4.
    Schepens MA, Kelder JC, Morshuis WJ, Heijmen RH, van Dongen EP, ter Beek HT. Long-term follow-up after thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2007;83:S851–5.CrossRefGoogle Scholar
  5. 5.
    Coselli JS, LeMaire SA, Preventza O, de la Cruz KI, Cooley DA, Price MD, et al. Outcomes of 3309 thoracoabdominal aortic aneurysm repairs. J Thorac Cardiovasc Surg. 2016;151:1323–37.CrossRefGoogle Scholar
  6. 6.
    Quiñones-Baldrich WJ, Nene SM, Gelabert HA, Moore WS. Rupture of the perivisceral aorta: atherosclerotic versus mycotic aneurysm. Ann Vasc Surg. 1997;11:331–41.CrossRefGoogle Scholar
  7. 7.
    Carrel TP, Signer C. Separate revascularization of the visceral arteries in thoracoabdominal aneurysm repair. Ann Thorac Surg. 1999;68:573–5.CrossRefGoogle Scholar
  8. 8.
    Gasparis AP, Da Silva MS, Semel L. Visceral patch rupture after repair of thoracoabdominal aortic aneurysm—a case report. Vasc Surg. 2001;35:491–4.CrossRefGoogle Scholar
  9. 9.
    Clouse WD, Marone LK, Davison JK, Dorer DJ, Brewster DC, LaMuraglia GM, et al. Late aortic and graft-related events after thoracoabdominal aneurysm repair. J Vasc Surg. 2003;37:254–61.CrossRefGoogle Scholar
  10. 10.
    Dias RR, Coselli JS, Stolf NA, Dias AR, Mady C, Oliveira SA. Aneurysmal dilation of the reimplant segment of the visceral vessels after thoracoabdominal aneurysm correction. Arq Bras Cardiol. 2003;81:273–8.CrossRefGoogle Scholar
  11. 11.
    Lombardi JV, Carpenter JP, Pochettino A, Sonnad SS, Bavaria JE. Thoracoabdominal aortic aneurysm repair after prior aortic surgery. J Vasc Surg. 2003;38:1185–90.CrossRefGoogle Scholar
  12. 12.
    Tshomba Y, Bertoglio L, Marone EM, Melissano G, Chiesa R. Visceral aortic patch aneurysm after thoracoabdominal aortic repair: conventional vs hybrid treatment. J Vasc Surg. 2008;48:1083–91.CrossRefGoogle Scholar
  13. 13.
    Suzuki K, Kazui T, Ohno T, Sugiki K, Doi H, Ohkawa Y. Re-reconstruction of visceral arteries with thoracoabdominal aortic replacement using a branched graft. Jpn J Thorac Cardiovasc Surg. 2005;53:217–9.CrossRefGoogle Scholar
  14. 14.
    LeMaire SA, Carter SA, Volguina IV, Laux AT, Milewicz DM, Borsato GW, et al. Spectrum of aortic operations in 300 patients with confirmed or suspected Marfan syndrome. Ann Thorac Surg. 2006;81:2063–78.CrossRefGoogle Scholar
  15. 15.
    Cochennec F, Kobeiter H, Gohel M, Leopardi M, Raux M, Majewski M, et al. Early results of physician modified fenestrated stent grafts for the treatment of thoraco-abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2015;50:583–92.CrossRefGoogle Scholar
  16. 16.
    van de Mortel RH, Vahl AC, Balm R, Buth J, Hamming JF, Schurink GW, et al. Collective experience with hybrid procedures for suprarenal and thoracoabdominal aneurysms. Vascular. 2008;16:140–6.CrossRefGoogle Scholar
  17. 17.
    Kasirajan K. Branched grafts for thoracoabdominal aneurysms: off-label use of FDA-approved devices. J Endovasc Ther. 2011;18:471–6.CrossRefGoogle Scholar
  18. 18.
    Juvonen T, Biancari F, Ylönen K, Perälä J, Rimpiläinen J, Lepojärvi M. Combined surgical and endovascular treatment of pseudoaneurysms of the visceral arteries and of the left iliac arteries after thoracoabdominal aortic surgery. Eur J Vasc Endovasc Surg. 2001;22:275–7.CrossRefGoogle Scholar
  19. 19.
    Flye MW, Choi ET, Sanchez LA, Curci JA, Thompson RW, Rubin BG, et al. Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm. J Vasc Surg. 2004;39:454–8.CrossRefGoogle Scholar
  20. 20.
    Bakken AM, Protack CD, Waldman DL, Davies MG. Hybrid debranching-endovascular repair of visceral patch aneurysm after thoracoabdominal aneurysm repair. Vasc Endovasc Surg. 2007;41:249–53.CrossRefGoogle Scholar
  21. 21.
    O’Connor DJ, Vouyouka A, Ellozy SH, Sundick SA, Lemasters P, Marin ML, et al. Stent graft repair of paraanastomotic aneurysms after open descending thoracic and thoracoabdominal aortic aneurysm repair. Ann Vasc Surg. 2013;27:693–8.CrossRefGoogle Scholar
  22. 22.
    Adam DJ, Berce M, Hartley DE, Robinson DA, Anderson JL. Repair of recurrent visceral aortic patch aneurysm after thoracoabdominal aortic aneurysm repair with a branched endovascular stent graft. J Vasc Surg. 2007;45:183–5.CrossRefGoogle Scholar
  23. 23.
    Gargiulo M, Gallitto E, Freyrie A, Stella A. Fenestrated endograft for recurrent paravisceral aortic pseudoaneurysm after thoracoabdominal aortic aneurysm open repair. J Vasc Surg. 2013;58:790–3.CrossRefGoogle Scholar
  24. 24.
    Bertoglio L, Mascia D, Cambiaghi T, Kahlberg A, Melissano G, Chiesa R. Fenestrated and branched endovascular treatment of recurrent visceral aortic patch aneurysm after open thoracoabdominal repair. J Vasc Interv Radiol. 2018;29:72–7.CrossRefGoogle Scholar
  25. 25.
    Bertoglio L, Mascia D, Cambiaghi T, Kahlberg A, Tshomba Y, Gomez JS, et al. Management of visceral aortic patch aneurysms after thoracoabdominal repair: open, hybrid and endovascular approach. J Vasc Surg. 2018;67:1358–69.Google Scholar
  26. 26.
    Chiesa R, Kahlberg A, Mascia D, Tshomba Y, Civilini E, Melissano G. Use of a novel hybrid vascular graft for sutureless revascularization of the renal arteries during open thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2014;60:622–30.CrossRefGoogle Scholar
  27. 27.
    de la Cruz KI, LeMaire SA, Weldon SA, Coselli JS. Thoracoabdominal aortic aneurysm repair with a branched graft. Ann Cardiothorac Surg. 2012;1:381–93.Google Scholar
  28. 28.
    Tshomba Y, Kahlberg A, Melissano G, Coppi G, Marone E, Ferrari D, et al. Comparison of renal perfusion solutions during thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2014;59:623–33.CrossRefGoogle Scholar
  29. 29.
    Verhoeven EL, Katsargyris A, Bekkema F, Oikonomou K, Zeebregts CJ, Ritter W, et al. Ten-year experience with endovascular repair of thoracoabdominal aortic aneurysms: results from 166 consecutive patients. Eur J Vasc Endovasc Surg. 2015;49:524–31.CrossRefGoogle Scholar
  30. 30.
    Maurel B, Delclaux N, Sobocinski J, Hertault A, Martin-Gonzalez T, Moussa M, et al. The impact of early pelvic and lower limb reperfusion and attentive peri-operative management on the incidence of spinal cord ischemia during thoracoabdominal aortic aneurysm endovascular repair. Eur J Vasc Endovasc Surg. 2015;49:248–54.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Luca Bertoglio
    • 1
    Email author
  • Alessandro Grandi
    • 1
  • Tommaso Cambiaghi
    • 1
  • Andrea Melloni
    • 1
  • Simone Salvati
    • 1
  1. 1.Division of Vascular Surgery“Vita—Salute” University, Scientific Institute H. San RaffaeleMilanItaly

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