Staged hybrid treatment of a patient with descending thoracic and abdominal aortic aneurysm (case report)
AbstractHere we describe a clinical case of successful staged treatment of descending thoracic and abdominal aorta aneurysmal lesions with unchanged segment of the visceral portion between them. An anatomical peculiarity of the abdominal aortic aneurysm was the presence of angulation and an aneurysmal lesion of the left iliac artery, thus requiring the use of a hybrid strategy. The patient had a high surgical risk associated with comorbidity. At the first stage, he underwent aortofemoral prosthetic repair and 3 months thereafter received an endograft implanted into the descending thoracic aorta with the positioning of the distal portion of the stent graft at the level of the XI thoracic vertebra. Previous aortofemoral prosthetic repair was an independent risk factor for spinal complications avoided by optimal perioperative and postoperative patient management. The control studies showed an adequate position of the stent graft, patency of the aortofemoral prosthesis, and no dilatation of the visceral portion of the aorta.
Funding. The study had no financial support.
Conflict of interest. The authors declare no conflicts of interest.
Authors’ contribution. Study conception and design – Ivanov L.N., Mukhin A.S.; data collection and handling – Naumov S.V., Kozina M.V., Yurasova E.V.; draft manuscript preparation – Ivanov L.N., Nagaev R.Yu., Pugin V.A.; manuscript revision – Mukhin A.S.
For citation: Ivanov L.N., Mukhin A.S., Nagaev R.Yu., Naumov S.V., Pugin V.A., Kozina M.V., Yurasova E.V. Staged hybrid treatment of a patient with descending thoracic and abdominal aortic aneurysm (case report). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2023; 29 (3): 46–52. DOI: https://doi.org/10.33029/1027-6661-2023-29-3-46-52 (in Russian)
Keywords:thoracoabdominal aneurysm; endovascular treatment of thoracic aortic aneurysms; spinal ischemia; previous abdominal aortic prosthetic repair
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