How to do itA Novel Approach for the Endovascular Repair of the Small Thoracic Aorta: Customizing Off-the-Shelf Endoluminal Grafts to Treat a Post-Coarctation Pseudoaneurysm
Section snippets
Technique
A left carotid subclavian artery bypass was performed the day prior to the endovascular procedure, because the pseudoaneurysm involved the left subclavian artery as demonstrated in Figure 2. Percutaneous access of the left common femoral artery was performed with a 9-French sheath that was introduced. Thoracic arch aortogram was performed through the left sheath with a pigtail catheter to delineate the arch and descending thoracic aorta and aneurysm. An intravascular ultrasound was performed
Comment
This case represents a novel approach of customizing off-the-shelf endovascular components for the small thoracic aorta. Until thoracic endoprostheses are developed that are smaller in diameter, this customized approach is the best solution when an endovascular approach is contemplated. Severe adult type coarctation accounts for 4% of congenital cardiovascular malformations, which are usually surgically corrected.
Stent graft repair of thoracic aneurysm has been shown to be feasible with
References (9)
Treatment of coarctation and late complications in the adult
Semin Thorac Cardiovasc Surg
(2005)- et al.
Predictors of aneurismal formation after surgical correction of aortic coarctation
J Am Coll Cardiol
(2002) - et al.
Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the Gore TAG thoracic endoprosthesis
J Vasc Surg
(2005) - et al.
Aortic aneurysms at the site of the repair of coarctation of the aorta: a review of 48 patients
Ann Thorac Surg
(1996)