Krónikus aortadissectio talaján kialakult thoracoabdominalis aneurysma endovascularis kezelése fenesztrált sztentgrafttal = Fenestrated endovascular repair of a thoracoabdominal aortic aneurysm in chronic dissection

Csobay-Novák, Csaba and Entz, László and Banga, Péter and Pólos, Miklós and Szabolcs, Zoltán and Csikós, Gergő and Fontanini, Daniele Mariastefano and Vecsey-Nagy, Milán and Szeberin, Zoltán (2021) Krónikus aortadissectio talaján kialakult thoracoabdominalis aneurysma endovascularis kezelése fenesztrált sztentgrafttal = Fenestrated endovascular repair of a thoracoabdominal aortic aneurysm in chronic dissection. ORVOSI HETILAP, 162 (31). pp. 1260-1264. ISSN 0030-6002

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Abstract

Thoracoabdominal aortic aneurysms developing in the chronic phase of an aortic dissection require multidisciplinary approach, experienced operators and advanced technology. The mortality and morbidity rate of these multistage operations were reduced with the latest technical achievements in endovascular repair, but they are still significant. Fenestrated endovascular aortic repair, an alternative of thoracoabdominal open repair, is associated with less mortal-ity and morbidity, shorter hospital stay. Using fenestrated devices in aortic dissection is usually technically demanding due to the dissection membrane. We report the case of a 56-year-old woman, who underwent ascending aortic repair due to type A aortic dissection. During the follow-up, a large thoracoabdominal aneurysm developed involving also the arch. We performed a three-stage operation starting with the open repair of the aortic arch using a 'frozen ele-phant trunk' device followed by a thoracic endovascular aortic repair of the descending aorta. The final stage was a fenestrated endovascular aortic repair, which is the first use of this technique in aortic dissection in Hungary.

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