doiSerbia

A case report of a hybrid procedure (visceral and partial aortic arch debranching) in the treatment of a challenging aneurysm of the thoracoabdominal aorta in the endovascular era

Sladojević Miloš (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia)
Končar Igor (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia)
Zlatanović Petar (Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia)
Jovanović Sanja (Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Belgrade, Serbia)
Davidović Lazar (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia)

Introduction. This paper aimed to present a hybrid approach as a less invasive and acceptable treatment. Case outline. Because of respiratory failure, the patient was deemed at high risk for open repair. Standard thoracic endovascular aortic repair (TEVAR) was unfeasible, so the patient underwent the hybrid procedure – partial aortic arch debranching at the first stage, followed by visceral debranching and endovascular exclusion of thoracic aortic aneurysm as a final procedure. The postoperative course was uneventful and the patient was discharged 10 days after TEVAR and visceral debranching. Conclusion. Staged hybrid procedure with combined debranching of the aortic arch and visceral arteries is feasible and should be considered as an alternative treatment option in patients with high-risk for open repair.

Keywords: endovascular procedure, aortic aneurysm, dissecting aneurysm

Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175008