Use of fenestrated-branched endovascular aneurysm repair to treat Carrel patch aneurysmal degeneration after open thoracoabdominal aortic aneurysm repair

Abstract

Two patients with a history of open type II thoracoabdominal aortic aneurysm repair presented with saccular aneurysmal degeneration of the Carrel patch. The degenerated segments measured 6.2 cm and 7.4 cm, respectively, and involved the celiac artery, superior mesenteric artery, and right renal artery. Both patients successfully underwent a custom fenestrated-branched endovascular aneurysm repair with downgoing branches to the celiac artery, superior mesenteric artery, and right renal artery and a stented fenestration to the left renal artery. Completion angiography demonstrated no endoleak and patent visceral-renal segments. Both patients were discharged home on postoperative day 2.

Parallel intercostal artery stenting and exclusion of symptomatic bucket-handle intercostal patch aneurysm

“…Most techniques involve coverage of the intercostal arteries in their entirety with TEVAR or fenestrated-branched endovascular aortic repair after open TAAA with either custom-made or physician-modified devices. 3 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 Intercostal stenting is described during treatment of true intercostal aneurysms or pseudoaneurysms, often for rupture. 13 , 14 , 15 Intercostal preservation has also been demonstrated during index fenestrated-branched endovascular aortic repair with dedicated side stents or scallops.…”