Covered Stents for True Subclavian Aneurysms in Patients with Degenerative Connective Tissue Disorders

Kasirajan, Karthikeshwar; Matteson, Brian; Marek, John; Langsfeld, Mark

doi:10.1177/152660280301000335

Cited by 37 publications

(20 citation statements)

References 13 publications

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“…Since Halsted first successfully combined ligation with resection of an SAA in 1892,5 surgical repair was recommended for all patients with an SAA to prevent potential complications 3. Endovascular stent graft treatment for arterial injuries began appearing in the literature over a decade ago 6,7,8,9. The evolution of endovascular technology has improved the stents available to vascular surgeons and interventionists in the management of SAAs.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Ruptured Subclavian Artery Aneurysm Presenting as Hemoptysis with a Covered Stent

et al. 2014

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An aneurysm of the subclavian artery is rare. Recently, we experienced a case of a ruptured subclavian artery aneurysm presenting as hemoptysis. The patient had experienced atypical chest discomfort, and computed tomography (CT) revealed a small aneurysm of the left subclavian artery (SCA). Hemoptysis occurred 2 weeks later. Follow-up CT showed a ruptured aneurysm at the proximal left SCA. Endovascular treatment with a graft stent was performed by bilateral arterial access with a 12-Fr introducer sheath placed via cutdown of the left axillary artery and an 8-Fr sheath in the right femoral artery. A self-expandable Viabahn covered stent measuring 13×5 mm was introduced retrogradely via the left axillary sheath and was positioned under contrast guidance with an 8-Fr JR4 guide through the femoral sheath. After the procedure, hemoptysis was not found, and the 3-month follow-up CT showed luminal patency of the left proximal SCA and considerable reduction of the hematoma.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Ruptured Subclavian Artery Aneurysm Presenting as Hemoptysis with a Covered Stent

et al. 2014

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“…5 Etiology is variable, and the most common causes of atherosclerosis are trauma and poststenotic dilatation in compressions present in the thoracic outlet syndrome. [6][7][8] However, these lesions are also associated with degenerative disorders of the connective tissue, such as cystic medial necrosis, Marfan's syndrome, Ehlers-Danlos syndrome, Turner's syndrome, giant-cell syndrome, and Takayasu's arteritis. In addition, genetic causes were identified, and there are three cases described in the literature.…”

Section: Discussionmentioning

confidence: 99%

Tratamento endovascular híbrido de aneurisma da artéria subclávia associado à síndrome de Marfan: relato de caso

Sacchi

Medeiros

Filho³

2008

J. vasc. bras.

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We report on a 46-year-old female patient with Marfan's syndrome and a right subclavian artery aneurysm following open repair of type A aortic dissection. The patient was treated with a hybrid approach, combining innominate to right common carotid stent grafting and carotid to right axillary artery bypass. The postoperative course was uneventful and a duplex ultrasound confirmed successful aneurysm exclusion.Keywords: Subclavian artery, Marfan's syndrome, endovascular procedures, stent graft. RESUMODescreve-se o caso de uma paciente feminina de 46 anos com s•ndrome de Marfan que foi diagnosticada com aneurisma da art‚ria subclƒvia direita ap"s cirurgia aberta para reparo de dissec… †o a"rtica tipo A. A paciente foi tratada por abordagem h•brida, que combinou o implante de uma endopr"tese recoberta da art‚ria inominada para a car"tida comum direita com uma ponte car"tida para a art‚ria axilar direita. O p"s-operat"rio transcorreu sem complica… ‡es, com a confirma… †o, por ultra-som, do sucesso da exclus †o do aneurisma.Palavras-chave: Art‚ria subclƒvia, s•ndrome de Marfan, procedimento endovascular, endopr"tese.

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“…Median clamping time of the CCA was 9.5 [6][7][8][9][10][11][12][13][14][15][16][17] min. A Matsui-Kitamura (MK) stent-graft (Kitamura Inc., Kanazawa, Japan) was used in cases 1 and 2, a Gore TAG (WL Gore) in cases 3 and 4 and the iliac extender of the Gore Excluder (WL Gore) in cases 5 and 6.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…Early and late thrombosis and stenosis may be of concern for patients who were treated with a stent-graft placed in the subclavian artery, which is extremely mobile and exposed to rotational forces during arm movements. [7][8][9] Basically, we indicate stent-graft placement according to the patient's risk for surgery and the anatomical suitability. As exercise can increase the risk of stent-related complications, the indication of stent-graft placement for subclavian artery has been limited to the patients 70 years or older in this study.…”

Section: Hybrid Repair Of Subclavian Artery Aneurysmmentioning

confidence: 99%

“…13) Most bypass grafts were made of ePTFE and the 5-year patency rate was 92%, indicating that artificial bypass grafts can result in excellent patency rates. We also used ePTFE grafts for all patients, and no graft occlusion was encountered during the follow-up period, nor was any cerebral complication associated with clamping of the CCA for 9.5 [6][7][8][9][10][11][12][13][14][15][16][17] min for construction of the supra-aortic bypass. However, one aortic dissection and two neurologic complications were encountered in the early and late term.…”

Section: Hybrid Repair Of Subclavian Artery Aneurysmmentioning

confidence: 99%

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Hybrid Repair of Proximal Subclavian Artery Aneurysm

Morimoto

Matsuda

Fukuda

et al. 2015

Annals of Vascular Diseases

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Objective: Conventional open repair for proximal subclavian artery aneurysms (SCAAs) requires cardiopulmonary bypass. However, patients with proximal SCAA can be treated with hybrid repair. Methods: Between 2007 and 2012, we performed hybrid repair to treat six consecutive patients with proximal SCAA (three left SCAAs, one right aberrant SCAA, two right SCAAs). Their median age was 73.5 [70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87] years, and the size of their aneurysm was 33.5 [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] mm. Thoracic endovascular aneurysm repair (TEVAR) only was used for one patient with left SCAA, TEVAR and supra-aortic bypass for two with left SCAA and one with right aberrant SCAA, and endovascular repair with reconstruction of the vertebral artery using the saphenous vein graft (SVG) for two with right SCAA. Results: The follow-up duration was 3.7 [0.2-6.8] years. There was no 30-day mortality and only one early complication consisting of a minor stroke after TEVAR for shaggy aorta. Two late deaths occurred, one caused by cerebral infarction due to occlusion of SVG to the dominant vertebral artery 2 months after the operation and the other by aortic dissection 5 years postoperatively. Conclusions: Hybrid repair can be a less-invasive alternative for proximal SCAA. Revascularization of neck vessels and TEVAR should be performed very carefully to prevent neurologic complications.

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Covered Stents for True Subclavian Aneurysms in Patients with Degenerative Connective Tissue Disorders

Abstract: Patients with degenerative connective tissue disorders may benefit from less invasive treatment with stent-grafts. The more flexible Viabahn stent-graft may be better able to adapt to arterial tortuosity. However, the long-term results of this new technique have not yet been established.

Cited by 37 publications

References 13 publications

Successful Treatment of a Ruptured Subclavian Artery Aneurysm Presenting as Hemoptysis with a Covered Stent

Successful Treatment of a Ruptured Subclavian Artery Aneurysm Presenting as Hemoptysis with a Covered Stent

Tratamento endovascular híbrido de aneurisma da artéria subclávia associado à síndrome de Marfan: relato de caso

Hybrid Repair of Proximal Subclavian Artery Aneurysm

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