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ludc webb

Nuno Dias

Associate professor

ludc webb

Single superior mesenteric artery periscope grafts to facilitate urgent endovascular repair of acute thoracoabdominal aortic pathology.

Author

  • Nuno Dias
  • Tim Resch
  • Björn Sonesson
  • Martin Malina

Summary, in English

Abstract Purpose: To assess the use of periscope grafts to the superior mesenteric artery (SMA) in extending the distal sealing zone of thoracic stent-grafts. Case Reports: Three patients with ruptured Crawford type I thoracoabdominal aortic aneurysms (TAAA) and 1 patient with a symptomatic type B dissection underwent endovascular repair; the celiac trunk was intraoperatively occluded in all patients. The thoracic stent-graft was extended to immediately above the most cranial renal artery, and the SMA was simultaneously stented from a femoral approach (periscope graft). All 4 periscope grafts were successfully implanted. One patient with rTAAA and intraoperative hemodynamic instability died in the perioperative period with a patent SMA. The other 3 patients had patent SMA periscope grafts and were free from abdominal symptoms at 14, 12, and 7 months; follow-up CT scans showed excluded aneurysms in the 2 TAAAs. The patient with type B dissection became asymptomatic but had persistent retrograde perfusion and expansion of the false lumen. Conclusion: Periscope grafts are a viable option for urgent endovascular repair of acute Crawford type I TAAA. In type B dissections, however, they are at most a bridging solution until more definitive exclusion of the false lumen is achieved.

Department/s

  • Department of Clinical Sciences, Malmö
  • Vascular Diseases - Clinical Research

Publishing year

2011

Language

English

Pages

656-660

Publication/Series

Journal of Endovascular Therapy

Volume

18

Issue

5

Document type

Journal article

Publisher

International Society of Endovascular Specialists

Topic

  • Cardiac and Cardiovascular Systems

Status

Published

Research group

  • Vascular Diseases - Clinical Research

ISBN/ISSN/Other

  • ISSN: 1545-1550