Abstract
Purpose: To describe a bailout technique for use during branched/fenestrated thoracoabdominal aortic aneurysm (TAAA) repair to address celiac artery (CA) dissection. Technique: The technique is demonstrated in a 69-year-old man who underwent fenestrated stent-graft repair of a 6-cm type III TAAA. The main fenestrated stent-graft was positioned without difficulty, and the renal and superior mesenteric arteries were stented. A stent-graft was placed in the CA, but angiography showed the vessel to be occluded by dissection beyond the stent-graft. Wire manipulations to regain access to the true lumen culminated in perforation. At this point, the gastroduodenal artery was catheterized with a 0.035-inch guidewire, which was advanced in retrograde fashion into the CA true lumen and then snared back to the left brachial artery forming a loop. After exchange for a 0.014-inch system, self-expanding stents were deployed into the hepatic artery. Postoperative recovery was uneventful, and the patient was discharged on day 6. At 1-year follow-up, the patient was doing very well. Imaging demonstrated no endoleak, no graft migration, and sac shrinkage to a diameter of 5.1 cm. Conclusion: The "loop technique" can be a very useful and effective bailout maneuver in regaining access to the true lumen of a dissected CA in patients undergoing branched/fenestrated thoracoabdominal aortic aneurysm repair.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 614-617 |
| Number of pages | 4 |
| Journal | Journal of Endovascular Therapy |
| Volume | 23 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 1 2016 |
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Keywords
- Celiac artery
- Dissection
- Fenestrated stent-graft
- Thoracoabdominal aortic aneurysm
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
The loop technique : Addressing celiac artery dissection in a branched and fenestrated endograft for the treatment of a type III thoracoabdominal aneurysm. / Erben, Young; Oderich, Gustavo; Gloviczki, Peter.
In: Journal of Endovascular Therapy, Vol. 23, No. 4, 01.08.2016, p. 614-617.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The loop technique
T2 - Addressing celiac artery dissection in a branched and fenestrated endograft for the treatment of a type III thoracoabdominal aneurysm
AU - Erben, Young
AU - Oderich, Gustavo
AU - Gloviczki, Peter
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Purpose: To describe a bailout technique for use during branched/fenestrated thoracoabdominal aortic aneurysm (TAAA) repair to address celiac artery (CA) dissection. Technique: The technique is demonstrated in a 69-year-old man who underwent fenestrated stent-graft repair of a 6-cm type III TAAA. The main fenestrated stent-graft was positioned without difficulty, and the renal and superior mesenteric arteries were stented. A stent-graft was placed in the CA, but angiography showed the vessel to be occluded by dissection beyond the stent-graft. Wire manipulations to regain access to the true lumen culminated in perforation. At this point, the gastroduodenal artery was catheterized with a 0.035-inch guidewire, which was advanced in retrograde fashion into the CA true lumen and then snared back to the left brachial artery forming a loop. After exchange for a 0.014-inch system, self-expanding stents were deployed into the hepatic artery. Postoperative recovery was uneventful, and the patient was discharged on day 6. At 1-year follow-up, the patient was doing very well. Imaging demonstrated no endoleak, no graft migration, and sac shrinkage to a diameter of 5.1 cm. Conclusion: The "loop technique" can be a very useful and effective bailout maneuver in regaining access to the true lumen of a dissected CA in patients undergoing branched/fenestrated thoracoabdominal aortic aneurysm repair.
AB - Purpose: To describe a bailout technique for use during branched/fenestrated thoracoabdominal aortic aneurysm (TAAA) repair to address celiac artery (CA) dissection. Technique: The technique is demonstrated in a 69-year-old man who underwent fenestrated stent-graft repair of a 6-cm type III TAAA. The main fenestrated stent-graft was positioned without difficulty, and the renal and superior mesenteric arteries were stented. A stent-graft was placed in the CA, but angiography showed the vessel to be occluded by dissection beyond the stent-graft. Wire manipulations to regain access to the true lumen culminated in perforation. At this point, the gastroduodenal artery was catheterized with a 0.035-inch guidewire, which was advanced in retrograde fashion into the CA true lumen and then snared back to the left brachial artery forming a loop. After exchange for a 0.014-inch system, self-expanding stents were deployed into the hepatic artery. Postoperative recovery was uneventful, and the patient was discharged on day 6. At 1-year follow-up, the patient was doing very well. Imaging demonstrated no endoleak, no graft migration, and sac shrinkage to a diameter of 5.1 cm. Conclusion: The "loop technique" can be a very useful and effective bailout maneuver in regaining access to the true lumen of a dissected CA in patients undergoing branched/fenestrated thoracoabdominal aortic aneurysm repair.
KW - Celiac artery
KW - Dissection
KW - Fenestrated stent-graft
KW - Thoracoabdominal aortic aneurysm
UR - http://www.scopus.com/inward/record.url?scp=84979587232&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84979587232&partnerID=8YFLogxK
U2 - 10.1177/1526602816649372
DO - 10.1177/1526602816649372
M3 - Article
C2 - 27189928
AN - SCOPUS:84979587232
VL - 23
SP - 614
EP - 617
JO - Journal of Endovascular Therapy
JF - Journal of Endovascular Therapy
SN - 1526-6028
IS - 4
ER -