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Case Reports
. 2023 Sep 25:39:29.
doi: 10.5758/vsi.230075.

Simultaneous Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm Combined with Saccular Thoracic Aortic Aneurysm

Minju Kim  1 , Jeong Hee Han  1 , Dae Hwan Kim  1 , Myunghee Yoon  1 , Hyuk Jae Jung  1
Affiliations
Case Reports

Simultaneous Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm Combined with Saccular Thoracic Aortic Aneurysm

Minju Kim et al. Vasc Specialist Int. .

Abstract

With the recent increase in imaging tests, coexisting abdominal aortic aneurysms (AAAs) and thoracic aortic aneurysms (TAAs) are being discovered accidentally. We report two cases of simultaneous endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) for AAA and TAA. Both 74-year-old and 79-year-old male with infrarenal AAA and saccular TAA were treated simultaneously with EVAR and TEVAR. Saccular TAAs were identified in the upper thoracic aorta during the evaluation of AAA. During endograft placement, carotid-subclavian bypass and cerebrospinal fluid (CSF) drainage were performed. Both patients were successfully discharged without spinal cord ischemia. Simultaneous EVAR and TEVAR can be considered for patients with AAA and saccular TAA in the upper thoracic aorta. Moreover, CSF drainage may be necessary to protect the spinal cord.

Keywords: Abdominal aortic aneurysm; Endovascular aortic repair; Simultaneous; Thoracic aortic aneurysm; Thoracic endovascular aortic repair.

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Conflict of interest statement

CONFLICTS OF INTEREST

Hyuk Jae Jung has been the associate editor of VSI since 2016. He was not involved in the review process. Otherwise, no potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
A 4.2 cm-sized saccular thoracic aortic aneurysm (arrow) involving the aortic arch in initial computed tomography (CT) angiography (A) and intra-op angiography (B). Initial CT angiography showed 5.6 cm sized infrarenal abdominal aorta (C). Both pathologies were present in the three-dimensional reconstructive image (D).
Fig. 2
Fig. 2
Intraoperative angiography showed full-covered graft with a bypass from the left carotid artery to the left subclavian artery (A). Endograft deployment on abdominal aortic aneurysm was performed successfully, and the embolization of the right internal iliac artery was also completed (B). Both procedure outcomes were depicted in a three-dimensional reconstructive image (C).
Fig. 3
Fig. 3
Initial computed tomography angiography showed multiple saccular aneurysms on the thoracic aorta (A) and a 5.6 cm-sized infrarenal abdominal aortic aneurysm (B). Both pathologies were presented in three-dimensional reconstructive images (C).
Fig. 4
Fig. 4
Intra-op angiography presented that saccular aneurysm on the upper thoracic aorta was covered with endograft deployment (A), and abdominal aortic aneurysm was also covered with endograft successfully (B). Both procedure outcomes were presented in the three-dimensional reconstructive image (C).
See this image and copyright information in PMC

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