Endovascular repair for a descending thoracic aortic aneurysm with a stent-graft covering the celiac artery: Report of two cases

Abstract

An adequate landing zone for fixation and sealing is necessary for endovascular aneurysm repair (EVAR). This report presents two cases of a successful EVAR for thoracic aortic aneurysms (TAA) with a stent-graft covering the celiac artery (CA) to secure a distal landing zone. Case 1 was a 61-year-old man with a chronic traumatic descending TAA 12 mm away from the CA. Case 2 was a 79-year-old man with a descending TAA proximal to the CA. Preoperative angiography and computed tomography (CT) scan revealed a normal visceral blood flow including the peripancreatic arteries. Endovascular aneurysm repair with coverage of the CA was performed in both cases. Angiography after the EVAR demonstrated good blood flow to the CA branches via the peripancreatic arteries and a CT scan showed thrombosed aneurysms. Both patients were discharged without any abdominal symptoms. Endovascular aneurysm repair with a stent-graft covering the CA may therefore be an acceptable endovascular approach in treating selected TAA patients with a limited distal landing zone.

Stenting of a gastroduodenal artery aneurysm: report of a case

“…Recanalization, with incidence rates of 9-43%, and organ ischemia are the most important long-term complications of this technique [12]. Complete aneurysm exclusion with preservation of the blood flow in the artery has been achieved recently using stent grafts, and Ishibashi et al [13] successfully delineated the advantages of this technique in two cases of endovascular repair of descending thoracic aorta aneurysm with a stent graft that covered the celiac axis as well. A stent graft is used not only for asymptomatic visceral aneurysms, but also for ruptured, leaking, or dissecting ones.…”

Midterm Results of Intentional Celiac Artery Coverage During TEVAR for Type B Aortic Dissection

“…The existence of collaterals between the CA and SMA makes this intentional coverage feasible, as has been shown in the treatment of TAA. [4][5][6][7][8] There is some debate over the confirmation of collaterals between the CA and the SMA. CTA seems to be sufficient for some vascular surgeons, 8 while others believe that CTA alone may be inadequate.…”

“…2 Among these branches, the superior mesenteric artery (SMA) and bilateral renal arteries must be kept patent, but intentional coverage of the celiac artery (CA) during TEVAR of thoracic aortic aneurysm (TAA) has been shown to be feasible and safe according to several clinical studies and reviews. [2][3][4][5][6][7][8] To date, though, the use of this maneuver in endovascular repair of TBAD has not, to our knowledge, been reported. Thus, we retrospectively reviewed our experience with intentional celiac artery coverage by a thoracic stent-graft when treating TBAD patients.…”

Simultaneous total gastrectomy and endovascular repair of an abdominal aortic aneurysm: Report of a case

“…23 The EVAR technique probably lowers the risk of aortic graft infection because the endograft is inserted via distal access sites into the intact aortic sac, never coming into contact with potential contaminants in the peritoneal cavity. 24,25 Porcellini et al demonstrated the benefi t of EVAR over open repair in patients with concurrent malignancy in terms of morbidity, mortality, and length of hospital stay. 26 In addition, they reported that the patients in their series who had EVAR had a lower mortality than those who had open repair, and this advantage was 28 Our patient suffered from both gastric cancer with a bleeding tendency and from an AAA with a diameter greater than 6 cm.…”