An unusual case of aortic rupture after deployment of a bare stent in the treatment of aortic dissection in a patient with giant-cell arteritis.

Rynio, Paweł; Kazimierczak, Arkadiusz; Gutowski, Piotr; Cnotliwy, Miłosław

doi:10.5114/wiitm.2017.67677

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…We try to avoid uncontrollable rupture of the intima in the visceral region (covered only by an aortic BMS), due to the fact that complete re-lamination is sometimes impossible in this region, no matter how hard it is forced. 12,26 Instead of STABILIZE (proposed by Mellisano 26 ), we prefer to reinforce the aortic BMS by a simple modification (proposed by He 8 ). In this technique, the thoracic stent-graft is deployed inside the distal BMS-XL.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to the potential risk of aortic rupture, and lack of information concerning follow up the STABILIZE technique was not widely accepted. 12 In order to improve the remodeling rate and reduce the frequency of late interventions, we introduced the E-PETTICOAT technique. 13,14 This is based on an extension of the standard Petticoat technique by the placement of 2 covered stents within the abdominal BMS as parallel iliac stent grafts, starting just below the renal artery and terminating below the distal tear, including down to the iliac bifurcation.…”

Section: Introductionmentioning

confidence: 99%

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Aortic Remodeling After Extended PETTICOAT Technique in Acute Aortic Dissection Type III B.

Kazimierczak

Rynio

Jędrzejczak

et al. 2020

Annals of Vascular Surgery

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Background: The aim of this paper was to evaluate a new technique called an ''extended'' provisional extension to induce complete attachment (e-PETTICOAT) technique. Methods: In this prospective single-center clinical study, the primary safety end mid-term remodeling is evaluated for the new endovascular technique. It was based on a standard Petticoat and limited Stabilize technique, extended by the placement of 2 covered stents within the abdominal bare metal stent as parallel iliac stent grafts down to the iliac bifurcations. Computed tomographic angiography was performed postoperatively to assess aortic remodeling after 12 and 24 months. Changes in aortic size and volumes of the false and true lumen were assessed. Results: Between January 2014 and December 2015, 17 patients were treated due to acute, complicated aortic dissection type III B, according to the DaBekey classification. All patients presented with branch vessel obstruction/compromise, including six cases with aortic impending rupture. A 100% technical success rate was recorded regarding the resolution of complications. Favorable remodeling was achieved in 100% of the cases. Complete false lumen thrombosis in the thoracic, infra-renal aorta and the iliac artery was noted. A small volume (9.51 ± 6.9 mL) contrast-enhanced false lumen in the abdominal aorta was observed in 76% of cases with stable aortic size after 1 and 2 years. No visceral branch occlusion, type I endo-leak, renal insufficiency or paraplegia was recorded in follow-up. Conclusions: The expanded PETTICOAT technique was feasible in achieving favorable remodeling in acute extensive aortic dissection. Extended followup is needed to ascertain long-term results. This article presents a series of 17 cases of a new endovascular method called E-PETTICOAT

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aortic Remodeling After Extended PETTICOAT Technique in Acute Aortic Dissection Type III B.

Kazimierczak

Rynio

Jędrzejczak

et al. 2020

Annals of Vascular Surgery

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“…Other complications of TAAs secondary to GCA include ischemic stroke, upper extremity stenosis, and death. 15 , 16 In a rare case, Rynio et al 17 reported that secondary to the inflammatory process within the aortic wall, the integrity of the wall is compromised leading to increased fragility as compared with noninflammed aortic aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Aortic dissection and accelerated aneurysmal degeneration in a patient with giant cell arteritis

Metias

Kelian

MacColl

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Giant cell arteritis (GCA) is associated with nonatheromatous aortic pathology. Here we present a case in which a 76-year-old woman with a biopsy-proven history of GCA and a previous repair of her ascending aortic aneurysm presents with an acute dissection of a 4-cm aneurysm in the descending thoracic aorta. It was treated using endovascular techniques. This report adds to a growing body of evidence that GCA is a risk factor for aortic dissection and nonatheromatous aortic aneurysms.

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“…This was done as a preparation of the landing zone for further procedures in the thoracic and thoracic-abdominal aorta in the future. A Tri-lobe balloon (Gore, Flagstaff, Arizona, 86003-2400 USA) was used to expand the stent grafts and their connections over the entire length, except for the last segment of the distal stent, to avoid aortic rupture or stent-induced new entry (SINE) [ 3 ]. Afterwards the guide was removed from the ventricle and valve.…”

Section: Methodsmentioning

confidence: 99%

Externalized transapical guidewire technique after artificial aortic valve replacement during complete endovascular aortic arch repair.

Jędrzejczak¹,

Rynio²,

Lewandowski³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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An externalized transapical guidewire (ETAG) technique has been used for safe delivery of high-profile devices through a tortuous aorta to zone 0, which is currently precluded after mechanical artificial aortic valve replacement (AVR). The aim of the study was to report one center’s experience (based on 3 cases) of a unique modification to the ETAG technique used for the first time during total endovascular aortic arch repair after AVR. This report contains technical notes regarding a new method of steering the guidewire from the apex inside the artificial aortic valve during total endovascular aortic arch repair after AVR and the details crucial in preparation for this mini-invasive procedure. As a conclusion, the ETAG technique could be performed after mechanical AVR with active positioning of the guidewire carried out under the control of transesophageal echocardiography.

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An unusual case of aortic rupture after deployment of a bare stent in the treatment of aortic dissection in a patient with giant-cell arteritis.

Cited by 6 publications

References 29 publications

Aortic Remodeling After Extended PETTICOAT Technique in Acute Aortic Dissection Type III B.

Aortic Remodeling After Extended PETTICOAT Technique in Acute Aortic Dissection Type III B.

Aortic dissection and accelerated aneurysmal degeneration in a patient with giant cell arteritis

Externalized transapical guidewire technique after artificial aortic valve replacement during complete endovascular aortic arch repair.

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