Simultaneous abdominal aortic replacement and thoracic stent-graft placement for multiple aortic aneurysms: report of a case

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 53; no. 9; p. 734
• Main Authors: Yoshida, H, Izumi, Y, Magishi, K, Ishikawa, N, Kubota, H, Uchida, S
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-08-2000
• Subjects: Aged; Aorta, Abdominal - surgery; Aorta, Thoracic - surgery; Aortic Aneurysm - surgery; Aortic Rupture - surgery; Blood Vessel Prosthesis Implantation; Humans; Male; Stents; Treatment Outcome
• ISSN: 0021-5252

Patients with aneurysmal disease involving both the thoracic and abdominal aorta have historically required simultaneous or sequential conventional operations. Staged operations were generally preferred, but we experienced that a patient had rupture of the second aneurysm after he finished initial treatment for the first aneurysm. We have implemented simultaneous operation using thoracic stent-graft placement. A 78-year-old male who had multiple aortic aneurysm involving both the thoracic and abdominal aorta underwent conventional abdominal aortic replacement with endovascular stent-graft placement into the distal arch of the thoracic aorta under fluoroscopic guidance. The stent-graft was composed of two units of self-expanding stainless-steel Z stent covered with an thin wall woven Dacron graft. Postoperative aortography showed no stent migration and no endoleak. Simultaneous abdominal aortic replacement and deployment of a thoracic stent-graft may be a valuable treatment option for these patients. However, careful long term follow up is necessary to prove the value and the effects of the endovascular treatment.