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Original method of treatment applied to the patent with rupturing thoracoabdominal aortic aneurysm, multi-organ insufficiency and advance limb ischemia
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Abstract
Presented is nonconventional method of treatment of patent with rupturing thoracoabdominal aortic aneurysm (Crawford type II), with multi-organ insufficiency and critical ischemia lower extremities due to dissection and thrombosis in the infra-renal part of an aneurysm. Due to high risk for surgery the patient was previously disqualified from the surgical treatment. On the new circumstances, that is the rupturing of an aneurysm and rest pain extremities forced us to try, to give it a chance for original method of treatment. From several vascular prostheses a special system of branches was constructed, it was then anastomosed by one and into coagulated sack of infra-renal part of an aneurysm. The branches of this system were then anastomosed with the renal arteries, mesenteric superior artery and with both common femoral arteries. In the second step through the technical branch of the system (conduit), the multi-segmented stent-graft was forced through the occluded aneurysm, thus restoring the blood flow to the kidneys, abdominal viscera and lower extremities. At end of the procedure there was a need for additional mesenteric to celiac anastomoses. In postoperative period transient functional renal impairment was observed, with no other adverse complications. After 12 months follow up the patient was found in the satisfactory condition. In bibliography there is a lack of description of the similar case.
Abstract
Presented is nonconventional method of treatment of patent with rupturing thoracoabdominal aortic aneurysm (Crawford type II), with multi-organ insufficiency and critical ischemia lower extremities due to dissection and thrombosis in the infra-renal part of an aneurysm. Due to high risk for surgery the patient was previously disqualified from the surgical treatment. On the new circumstances, that is the rupturing of an aneurysm and rest pain extremities forced us to try, to give it a chance for original method of treatment. From several vascular prostheses a special system of branches was constructed, it was then anastomosed by one and into coagulated sack of infra-renal part of an aneurysm. The branches of this system were then anastomosed with the renal arteries, mesenteric superior artery and with both common femoral arteries. In the second step through the technical branch of the system (conduit), the multi-segmented stent-graft was forced through the occluded aneurysm, thus restoring the blood flow to the kidneys, abdominal viscera and lower extremities. At end of the procedure there was a need for additional mesenteric to celiac anastomoses. In postoperative period transient functional renal impairment was observed, with no other adverse complications. After 12 months follow up the patient was found in the satisfactory condition. In bibliography there is a lack of description of the similar case.
Keywords
thoracoabdominal aortic aneurysm, surgical treatment, stent-graft repair, hybrid operation
About this articleTitle
Original method of treatment applied to the patent with rupturing thoracoabdominal aortic aneurysm, multi-organ insufficiency and advance limb ischemia
Journal
Issue
Article type
Case report
Pages
25-31
Published online
2014-04-24
Page views
738
Article views/downloads
5766
Bibliographic record
Acta Angiologica 2014;20(1):25-31.
Keywords
thoracoabdominal aortic aneurysm
surgical treatment
stent-graft repair
hybrid operation
Authors
Waldemar Macioch
Jerzy Leszczyński
Małgorzata Szostek
Wawrzyniec Jakuczun
Tomasz Ostrowski
Andrzej Kosicki
Tomasz Brzeziński
Ryszard Pogorzelski
Maciej Skórski