open access

Vol 24, No 1-2 (2022)
Case report
Published online: 2023-07-25
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Multi-staged hybrid therapy of dissected thoracoabdominal aortic aneurysm

Wiktoria Kuczmik1, Agata Suleja1, Karol Magiera1, Maciej Juśko2, Piotr Kasprzak3, Wacław Kuczmik2
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Chirurgia Polska 2022;24(1-2):40-46.
Affiliations
  1. Koło Naukowe Studenckiego Towarzystwa Naukowego przy Katedrze i Klinice Chirurgii Ogólnej, Naczyń, Angiologii i Flebologii Śląskiego Uniwersytetu Medycznego, Katowice (Student Research Group of Student Scientific Society at Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Medical University of Silesia, Katowice, Poland)
  2. Katedra i Klinika Chirurgii Ogólnej, Naczyń, Angiologii i Flebologii Śląskiego Uniwersytetu Medycznego, Katowice (Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Medical University of Silesia, Katowice, Poland)
  3. Klinika Chirurgii Naczyń, Uniwersytet w Regensburgu, Regensburg, Niemcy (Department of Vascular Surgery, University of Regensburg, Germany)

open access

Vol 24, No 1-2 (2022)
Case reports
Published online: 2023-07-25

Abstract

Dissecting thoracoabdominal aortic aneurysm (TAAA) is still a huge challenge for modern medicine. The treatment of TAAA uses the methods of classical surgery, endovascular surgery and a combination of both techniques. Regardless of the treatment method used, apart from perioperative mortality and renal failure, ischemia of the spinal cord with the risk of paresis and even paraplegia of the lower limbs is still a significant, dramatic complication. Despite the use of various methods of prevention, spinal cord ischemia still affects many patients treated for TAAA. Multistage endovascular or hybrid therapy in dissecting TAAA may be a new way to reduce the risk of perioperative complications in electively treated patients.

Abstract

Dissecting thoracoabdominal aortic aneurysm (TAAA) is still a huge challenge for modern medicine. The treatment of TAAA uses the methods of classical surgery, endovascular surgery and a combination of both techniques. Regardless of the treatment method used, apart from perioperative mortality and renal failure, ischemia of the spinal cord with the risk of paresis and even paraplegia of the lower limbs is still a significant, dramatic complication. Despite the use of various methods of prevention, spinal cord ischemia still affects many patients treated for TAAA. Multistage endovascular or hybrid therapy in dissecting TAAA may be a new way to reduce the risk of perioperative complications in electively treated patients.
Get Citation

Keywords

dissecting thoracoabdominal aortic aneurysm, endovascular treatment, branched stent graft (bEVAR), fenestrated stent graft (fEVAR), hybrid treatment

About this article
Title

Multi-staged hybrid therapy of dissected thoracoabdominal aortic aneurysm

Journal

Chirurgia Polska (Polish Surgery)

Issue

Vol 24, No 1-2 (2022)

Article type

Case report

Pages

40-46

Published online

2023-07-25

Page views

342

Article views/downloads

389

DOI

10.5603/ChP.2022.0006

Bibliographic record

Chirurgia Polska 2022;24(1-2):40-46.

Keywords

dissecting thoracoabdominal aortic aneurysm
endovascular treatment
branched stent graft (bEVAR)
fenestrated stent graft (fEVAR)
hybrid treatment

Authors

Wiktoria Kuczmik
Agata Suleja
Karol Magiera
Maciej Juśko
Piotr Kasprzak
Wacław Kuczmik

References (12)
  1. Kalder J, Kotelis D, Jacobs MJ. [Thoracoabdominal aortic aneurysm]. Chirurg. 2016; 87(9): 797–810.
  2. Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018; 67(1): 2–77.e2.
  3. Kheirelseid E, Gardiner R, Haider SN, et al. Endovascular repair of thoracoabdominal aortic aneurysm (TAAA): early experience. Irish Journal of Medical Science. 2013; 183(2): 153–160.
  4. Kitpanit N, Ellozy SH, Connolly PH, et al. Risk factors for spinal cord injury and complications of cerebrospinal fluid drainage in patients undergoing fenestrated and branched endovascular aneurysm repair. J Vasc Surg. 2021; 73(2): 399–409.e1.
  5. Rocha RV, Lindsay TF, Nasir D, et al. Risk factors associated with long-term mortality and complications after thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2022; 75(4): 1135–1141.e3.
  6. Kuzniar MK, Wanhainen A, Tegler G, et al. Endovascular treatment of chronic aortic dissection with fenestrated and branched stent grafts. J Vasc Surg. 2021; 73(5): 1573–1582.e1.
  7. Kusadokoro S, Hori D, Yuri K, et al. Dissected thoracoabdominal aortic aneurysm repair with modified parallel endografting. J Card Surg. 2020; 35(11): 3220–3223.
  8. Pantaleo A, Jafrancesco G, Buia F, et al. Distal Stent Graft-Induced New Entry: An Emerging Complication of Endovascular Treatment in Aortic Dissection. Ann Thorac Surg. 2016; 102(2): 527–532.
  9. Spanos K, Kölbel T, Kubitz JC, et al. Risk of spinal cord ischemia after fenestrated or branched endovascular repair of complex aortic aneurysms. J Vasc Surg. 2019; 69(2): 357–366.
  10. Harrison SC, Agu O, Harris PL, et al. Elective sac perfusion to reduce the risk of neurologic events following endovascular repair of thoracoabdominal aneurysms. J Vasc Surg. 2012; 55(4): 1202–1205.
  11. Jayia P, Constantinou J, Hamilton H, et al. Temporary Perfusion Branches to Decrease Spinal Cord Ischemia in the Endovascular Treatment of Thoraco-Abdominal Aortic Aneurysms. AORTA. 2018; 03(02): 56–60.
  12. Kasprzak PM, Gallis K, Cucuruz B, et al. Editor's choice--Temporary aneurysm sac perfusion as an adjunct for prevention of spinal cord ischemia after branched endovascular repair of thoracoabdominal aneurysms. Eur J Vasc Endovasc Surg. 2014; 48(3): 258–265.

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