We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Emergent Total Endovascular Arch Repair for Contained Aortic Arch Rupture: Another Tool in the Box.
- Authors
Kus, Nicole; Robinson, Justin A.; Hall, Michael R.; Ghoreishi, Mehrdad; Taylor, Bradley; Toursavadkohi, Shahab
- Abstract
To date, emergent total endovascular aortic arch repair has not been described in the literature. We present a 67-year-old female with a poorly differentiated posterior mediastinal sarcoma. Imaging obtained was concerning for intravascular extension of the tumor into the thoracic aorta. While awaiting radiation therapy, the patient complained of worsening chest and arm pain, vital signs demonstrating tachypnea and hypoxia. Subsequent imaging revealed an increase in vascular erosion, concerning for a contained rupture, with complete obliteration of the left mainstem bronchus. The patient was emergently taken for percutaneous endovascular repair of her aortic arch. A three-vessel physician modified fenestrated graft was created and deployed with concurrent stenting of the innominate, left carotid, and left subclavian arteries. Interval computed tomography angiography revealed patency in all stented vessels, with no endoleak and no evidence of pseudoaneurysm. The patient was able to undergo chemotherapy with favorable decrease in tumor burden. Total endovascular aortic arch repair, when planned carefully, is an attractive option in high-risk patients who are otherwise not ideally suited for open total arch replacement.
- Subjects
ENDOVASCULAR aneurysm repair; BLOOD vessels; CANCER chemotherapy; AORTIC rupture; TREATMENT effectiveness; BLOOD vessel prosthesis; CANCER patients; FALSE aneurysms; ENDOVASCULAR surgery; COMPUTED tomography; PROSTHESIS design &; construction; ANGIOGRAPHY; CATHETERIZATION; AORTIC arch aneurysms
- Publication
Vascular & Endovascular Surgery, 2023, Vol 57, Issue 7, p771
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/15385744231170919