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Case Reports
. 2019 Nov 22;5(4):544-548.
doi: 10.1016/j.jvscit.2019.06.009. eCollection 2019 Dec.

Consecutive failing proximal landing zones

Côme Bosse  1 , Thomas Le Houérou  1 , Raphael Soler  1 , Dominique Fabre  1 , Stéphan Haulon  1
Affiliations
Case Reports

Consecutive failing proximal landing zones

Côme Bosse et al. J Vasc Surg Cases Innov Tech. .

Abstract

We report the case of a 77-year-old man who presented with successive aortic aneurysms during a 12-year period. He was first treated in 2006 for an abdominal aortic aneurysm with a bifurcated endograft, then in 2016 for a tender type IV thoracoabdominal aortic aneurysm with a proximal aortic cuff with in situ laser fenestrations. He presented in 2018 with a 9-cm distal thoracic aorta aneurysm managed by an off-the-shelf t-Branch endograft (Cook Medical, Bloomington, Ind). The perioperative course was uneventful, and 6-month follow-up computed tomography scan has shown freedom from endoleaks and branch patency. This case illustrates that apparently "healthy" aortic necks can degenerate after endovascular aneurysm repair.

Keywords: Abdominal aorta; Aneurysm; Branched stent graft; Endograft; Reintervention; Thoracic endovascular aortic repair.

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Figures

Fig 1
Fig 1
Computed tomography (CT) scan from 2016 showing a type IA endoleak with three-dimensional volume rendered reconstruction (A) and coronal (B) and axial (C) views.
Fig 2
Fig 2
Computed tomography (CT) scan at 1-year follow-up after proximal extension and in situ laser fenestration with total exclusion of the aneurysm with three-dimensional volume rendered reconstruction (A) and coronal (B) and axial (C) views.
Fig 3
Fig 3
Three-dimensional volume-rendered reconstruction (A) and coronal (B) and sagittal (C) orientations of the preoperative computed tomography (CT) scan in 2018 showing an aneurysmal evolution of the distal thoracic aorta (DTA).
Fig 4
Fig 4
Computed tomography (CT) scan at 6-month follow-up after thoracoabdominal multibranched endograft implantation inside the previous endograft: total exclusion of the aneurysm with three-dimensional volume rendered reconstructions (A and B) and sagittal view (C). This shows a total of three endografts deployed one inside the other.
See this image and copyright information in PMC

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