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Nuno Dias

Associate professor

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Endovascular redo aortic surgery

Author

  • Jacob Budtz-Lilly
  • Kiattisak Hongku
  • Björn Sonesson
  • Nuno Dias
  • Tim Resch

Summary, in English

Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger abdominal aortic aneurysm necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing. This can be achieved with Palmaz stents, endoanchors, and extension with fenestrated or branched endovascular repair. Thoracic aortic coverage may be required, and revascularization of the left subclavian artery should be considered. Technical issues such as these, as well as target vessel cannulation and accommodation of the new graft within the previous implanted graft, require experience and careful planning. Distal extension can likewise resolve a failing repair, and this may require the use of internal iliac artery embolization or iliac-branch devices. Redo aortic operations are technically demanding and are carried out with increased risks. Improving technology, such as fusion imaging, should mitigate some of this risk and are recommended.

Publishing year

2017-12-01

Language

English

Pages

854-860

Publication/Series

Journal of Cardiovascular Surgery

Volume

58

Issue

6

Document type

Journal article review

Publisher

Edizioni Minerva Medica

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Abdominal
  • Aorta
  • Aortic aneurysm
  • Endovascular procedures

Status

Published

ISBN/ISSN/Other

  • ISSN: 0021-9509