Treatment of Aortic Coarctation by Self-expanding Thoracic Endograft with Left Subclavian In Situ Laser Fenestration
Standard
Treatment of Aortic Coarctation by Self-expanding Thoracic Endograft with Left Subclavian In Situ Laser Fenestration. / Law, Yuk; Tsilimparis, Nikolaos; Aleed, Shadi; Rohlffs, Fiona; Schofer, Niklas; Debus, Eike S; Müller, Goetz; Kölbel, Tilo.
in: ANN VASC SURG, Jahrgang 56, 04.2019, S. 350.e9-350.e13.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Treatment of Aortic Coarctation by Self-expanding Thoracic Endograft with Left Subclavian In Situ Laser Fenestration
AU - Law, Yuk
AU - Tsilimparis, Nikolaos
AU - Aleed, Shadi
AU - Rohlffs, Fiona
AU - Schofer, Niklas
AU - Debus, Eike S
AU - Müller, Goetz
AU - Kölbel, Tilo
N1 - Copyright © 2018 Elsevier Inc. All rights reserved.
PY - 2019/4
Y1 - 2019/4
N2 - BACKGROUND: Thoracic endovascular aortic repair (TEVAR) with self-expanding endograft is increasingly used as a viable treatment option for adult aortic coarctation (AC).METHODS: We hereby reported a 55-year-old gentleman with late presentation of AC, treated by a novel strategy with thoracic endograft and in situ laser fenestration for left subclavian artery (LSA) revascularization.RESULTS: AC was incidentally discovered during coronary angiogram as an investigation for his angina pectoris. TEVAR with self-expanding endograft was chosen because preoperative computer tomography scan showed ectatic thoracic aorta and stenosis just distal to the LSA. The patient was planned for a timely second-stage aortic valve replacement and coronary artery bypass grafting using left internal mammary artery shortly after TEVAR, which required a patent LSA. The procedure was arranged semiurgently. A 34-mm thoracic tube endograft was placed across the coarctation with proximal landing distal to the left common carotid artery. In situ fenestration was created by laser catheter through retrograde left brachial access. The fenestration was then enlarged by balloon dilatation and bridged to the left subclavian origin with a 16-mm balloon-expandable covered stent.CONCLUSIONS: TEVAR with in situ fenestration for LSA is a reliable choice for adult AC. The technique added to the armamentarium of treatment options.
AB - BACKGROUND: Thoracic endovascular aortic repair (TEVAR) with self-expanding endograft is increasingly used as a viable treatment option for adult aortic coarctation (AC).METHODS: We hereby reported a 55-year-old gentleman with late presentation of AC, treated by a novel strategy with thoracic endograft and in situ laser fenestration for left subclavian artery (LSA) revascularization.RESULTS: AC was incidentally discovered during coronary angiogram as an investigation for his angina pectoris. TEVAR with self-expanding endograft was chosen because preoperative computer tomography scan showed ectatic thoracic aorta and stenosis just distal to the LSA. The patient was planned for a timely second-stage aortic valve replacement and coronary artery bypass grafting using left internal mammary artery shortly after TEVAR, which required a patent LSA. The procedure was arranged semiurgently. A 34-mm thoracic tube endograft was placed across the coarctation with proximal landing distal to the left common carotid artery. In situ fenestration was created by laser catheter through retrograde left brachial access. The fenestration was then enlarged by balloon dilatation and bridged to the left subclavian origin with a 16-mm balloon-expandable covered stent.CONCLUSIONS: TEVAR with in situ fenestration for LSA is a reliable choice for adult AC. The technique added to the armamentarium of treatment options.
KW - Angioplasty, Balloon/instrumentation
KW - Aorta, Thoracic/diagnostic imaging
KW - Aortic Coarctation/diagnostic imaging
KW - Aortography/methods
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/instrumentation
KW - Computed Tomography Angiography
KW - Humans
KW - Laser Therapy
KW - Male
KW - Middle Aged
KW - Prosthesis Design
KW - Stents
KW - Subclavian Artery/diagnostic imaging
KW - Treatment Outcome
U2 - 10.1016/j.avsg.2018.07.068
DO - 10.1016/j.avsg.2018.07.068
M3 - SCORING: Journal article
C2 - 30342211
VL - 56
SP - 350.e9-350.e13
JO - ANN VASC SURG
JF - ANN VASC SURG
SN - 0890-5096
ER -