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Review
. 2015 Apr 1;3(2):61-6.
doi: 10.12945/j.aorta.2015.14-046. eCollection 2015 Apr.

Saccular Aneurysms of the Transverse Aortic Arch: Treatment Options Available in the Endovascular EraBased on a Presentation at the 2013 VEITH Symposium, November 19-23, 2013 (New York, NY, USA)

Ourania Preventza  1 , Joseph S Coselli  1
Affiliations
Review

Saccular Aneurysms of the Transverse Aortic Arch: Treatment Options Available in the Endovascular EraBased on a Presentation at the 2013 VEITH Symposium, November 19-23, 2013 (New York, NY, USA)

Ourania Preventza et al. Aorta (Stamford). .

Abstract

Saccular aneurysms of the aortic arch, whether single or multiple, are uncommon. The choice of repair technique is influenced by patients' comorbidities and age. Repairing saccular aneurysms with traditional open techniques can be technically demanding; therefore, endovascular technology and a variety of hybrid approaches have been developed to facilitate such repairs and, potentially, to improve clinical outcomes, especially in high-risk patients. There have been no large, randomized studies to compare the outcomes of these different treatment options in patients with single or multiple saccular aneurysms of the arch. In this review, we outline the etiology and common locations of these aneurysms, the different open, completely endovascular, and hybrid techniques used to treat them, and the treatment selection process.

Keywords: Aortic arch; Chimney and snorkel technique; Hybrid technique; Saccular aneurysms.

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Conflict of interest statement

W. L. Gore & Associates and Cook Medical, Inc have provided travel expenses for Dr. Preventza in the past. Dr. Preventza serves as a consultant for Medtronic, Inc. Dr. Coselli was provided program support by and has given lectures for W. L. Gore & Associates, and he serves as principal investigator for clinical trials conducted by W.L. Gore & Associates, Medtronic, Inc., and Cook Medical. In addition, Dr. Coselli serves as a consultant to and receives royalties from Vascutek Ltd., a subsidiary of Terumo Corporation.

Figures

Figure 1.
Figure 1.
Intraoperative angiograms showing aortic arch debranching of all head vessels. (A) Aorto-innominate bypass, aorto– left common carotid artery (LCCA) bypass, and aorto–left subclavian artery (LSCA) bypass are performed, and multiple saccular aneurysms of the arch are visible. (B) Debranching is complete, and all saccular aneurysms have been excluded with two endovascular stentgrafts. (From Preventza O, Aftab M, Coselli JS. Hybrid techniques for complex aortic arch surgery. Tex Heart Inst J. 2013;40:568-571. Reproduced with permission.)
See this image and copyright information in PMC

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