doiSerbia

Hybrid procedure for a descending thoracic and subclavian artery aneurysm in a patient with previous abdominal aortic surgery: Case report

Radak Đorđe (School of Medicine, Belgrade + "Dedinje" Cardiovascular Institute, Vascular Surgery Clinic, Belgrade)
Tanasković Slobodan ("Dedinje" Cardiovascular Institute, Vascular Surgery Clinic, Belgrade)
Unić-Stojanović Dragana ("Dedinje" Cardiovascular Institute, Clinic for Anesthesiology and Intensive Care, Belgrade)
Jović Miomir (School of Medicine, Belgrade + "Dedinje" Cardiovascular Institute, Clinic for Anesthesiology and Intensive Care, Belgrade)
Babić Srđan ("Dedinje" Cardiovascular Institute, Vascular Surgery Clinic, Belgrade)
Sagić Dragan (School of Medicine, Belgrade + "Dedinje" Cardiovascular Institute, Clinic for Radiology, Belgrade)

Introduction. Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with previous abdominal aortic surgery in whom hybrid vascular procedure for descending aorta and left subclavian artery aneurysm was performed. Case Outline. A 63-year-old female patient was admitted for computed tomography angiography. Descending aorta aneurysm (7.6 cm) as well as aneurysm of the left subclavian artery (LSA) was noted. Eight years ago she underwent abdominal aortic aneurysm resection and aortoiliac bypass. Standard TEVAR (thoracic endovascular aortic repair) procedure couldn’t be done due to small dimensions of previous “Y” graft (12.6 mm), so first we did LSA transposition and after three days hybrid procedure. After “Y” graft exposure, anastomosis between the corps of “Y” graft and tubular graft 10 mm was created and through this conduit thoracic stent-graft was placed followed by complete “Y” graft replacement. After 6 months angiography showed regular postoperative findings. Conclusion. Combined surgical and endovascular procedures in thoracic aorta pathology treatment could be useful solutions with favorable outcome.

Keywords: thoracic endovascular aortic repair (TEVAR), hybrid procedure, thoracic aorta aneurysm

Projekat Ministarstva nauke Republike Srbije, br. 41002