#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Hybrid Procedures in the Treatment of Type IV and V Thoracoabdominal Aneurysms


Authors: P. Utíkal 1;  M. Köcher 2;  J. Koutná 3;  P. Bachleda 1;  P. Dráč 1;  M. Černá 2;  J. Herman 1;  L. Kalinová 1
Authors‘ workplace: II. chirurgická klinika FN a LF UP v Olomouci, přednosta: doc. MUDr. Petr Bachleda, CSc. 1;  Radiologická klinika FN a LF UP v Olomouci, přednosta: prof. MUDr. Miroslav Heřman, Ph. D. 2;  Klinika anesteziologie a resuscitace FN a LF UP v Olomouci, přednosta: † MUDr. Oldřich Marek, Ph. D. 3
Published in: Rozhl. Chir., 2010, roč. 89, č. 1, s. 9-17.
Category: Monothematic special - Original

Overview

Objective:
To evaluate our experience with hybrid endovascular and open surgical treatment of thoracoabdominal aneurysms.

Material and methods:
Between 1996 and 2008 8 patients with thoracoabdominal aneurysm (6 Crawford type IV and 2 type V) from the total of 257 aortic aneurysms with elective endovascular repair were treated using hybrid procedure. A retrograde revascularisation of visceral and renal arteries through the open access and endovascular exclusion of aneurysms using a stent-graft were done.

Results:
A primar technical success of the hybrid procedure was in all cases. There was no severe ischaemia of visceral organs, kidneys (no need of haemodialysis) or spinal cord (paraplegia). One patient died on an acute pancreatitis 14 postperative day. Further follow up (in range 16–52 monthes) showed henceforth a successful exclusion of all the aneurysms without evidence of endoleak and patency of all bypasses with a good function of revascularised organs.

Conclusion:
Owing to minimal haemodynamic load and technical simplicity with a short time of organ ischaemia hybrid procedure represents an acceptable possibility of type IV and V thoracoabdominal aneurysms repair.

Key words:
thoracoabdominal aortic aneurysm – hybrid procedure – endovascular exclusion – visceral revascularisation


Sources

1. Svensson, L. G., Crawford, E. S., Hess, K. R., Coselli, J. S., Safi, H. J. Experience with 1509 patients undergoing thoracoabdominal aortic operations. J. Vasc. Surg., 1993; 17: 357–368.

2. Wahlgren, M. C., Wahlberg, E. Management of thoracoabdominal aneurysm type IV. Eur. J. Vasc. Endovasc. Surg., 2005; 29: 116–123.

3. Ballard, J. L., Abou-Zamzam Jr, A. M., Teruya, T. H. Type III and IV thoracoabdominal aortic aneurysm repair: results of a trifurcated/two-graft technique. J. Vasc. Surg., 2002; 36(2): 211–216.

4. Parodi, J. C., Palmaz, J. C., Barone, H. D. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann. Vasc. Surg., 1991; 5: 491–499.

5. Taufelsbauer, H., Prusa, A .M., Wolff, K., Polterauer, P., Nanobashvili, J., Prager, M., Holzenbein, T., Thurnher, S., Lammer, J., Schemper, M., Kretschmer, G., Huk, I. Endovascular stent-grafting versus open surgical operation in patients with infrarenal aortic aneurysms. A propensity score – adjusted analysis. Circulation, 2002; 106: 782–787.

6. May, J., White, G. H., Yu, W., Ly, C. N., Waugh, R., Stehen, M. S. Concurent comparison of endoluminal versus open repair in the treatment of abdominal aortic aneurysms: analysis of 303 patients by life-table method. J. Vasc. Surg., 1998; 27: 213–221.

7. Dake, M., Miller, D., Semba, C., et al. Transluminal placement of endovascular stent grafts for the treatment of descending thoracic aortic aneurysms. N. Engl. J. Med., 1994; 1331: 1721–1734.

8. Chaikoff, E. L., Blankenstein, J. D., Harris, P. L., White, G. H., Zarins, Ch. K., Bernhard, V. M., Matsumura, J. S., May, J., Veith, F. J., Fillinger, M. F., Rutherford, R. B., Kent, K. G., for the Ad Hoc Committee for Standardized Reporting Practices in Vascular Surgery of the Society for Vascular Surgery/American Association for Vascular Surgery. Reporting standards for endovascular aortic aneurysm repair. J. Vasc. Surg., 2002; 35: 1048–1060.

9. Quinones-Baldrich, W. J., Panetta, T. F., Vescera, C. L., et al. Repair of type IV thoracoabdominal aneurysm with combined endovascular and surgical approach. J. Vasc. Surg., 1999; 30: 555–560.

10. Watanabe, Y., Ishimaru, S., Kawaguchi, S., Shimazaki, T., Yokoi, Y., Ito, M., Obitsu, Y., Ishikawa, M. Successful endografting with simultaneus visceral bypass grafting for severly calcified thorakoabdominal aortic aneurysm. J. Vasc. Surg., 2002; 35(2): 397–399.

11. Kotsis, T., Scharrer-Palmer, R., Kapfer, X., Liewald, F., Gorich, J., Sunder-Plassmann, L., Orend, K. H. Treatment of thoracoabdominal aortic aneurysms with a combined endovascular and surgical approach. Int. Angiol., 2003; 22(2): 125–133.

12. Iguro, Y., Yotsumoto, G., Ishizaki, N., Arata, K., Sakata, R. Endovascular stent-graft repair for throracoabdominal aneurysm after reconstruction of the superior mesenteric and celiac arteries. J. Thorac. Cardiovasc. Surg., 2003; 125: 956–958.

13. Flye, M. W., Choi, E. T., Sanchez, L. A., Curci, J. A., Thompso, R. W., Rubin, B. G., Geraghty, P. J., Sicard, G. A. Retrograde visceral vessel revascularisation followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm. J. Vasc. Surg., 2004; 39(2): 454–458.

14. Chiesa, R., Mellisano, G., Civilini, E., Setacci, F., Tshomba, Y., Anzuini, A. Two-stage combined endovascular and surgical approach for recurrent thoracoabdominal aortic aneurysm. J. Endovasc. Ther., 2004; 11(3): 330–333.

15. Utíkal, P., Köcher, M., Bachleda, P., Dráč, P., Černá, M., Buriánková, E. Iliac-renal bypass in EVAR of AAA with renal arteries arissing from aneurysmal sac. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc, 2004; 148: 179–181.

16. Utíkal, P., Köcher, M., Koutná, J., Bachleda, P., Dráč, P., Černá, M., Buriánková, E., Herman, J. Combined strategy in AAA elective treatment. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc, 2005; 149(1): 159–163.

17. Utíkal, P., Köcher, M., Koutná, J., Bachleda, P., Dráč, P., Černá, M., Buriánková, E., Herman, J. Treatment possibility for AAA of the visceral branches region. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc, 2005; 149(1): 165–168.

18. Bonardelli, S., De Lucia, M., Cervi, E., Pandolfo, G., Maroldi, R., Battaglia, G., Gargano, M., Matheis, A., Stefano, M. G. Combined endovascular and surgical approach (hybrid treatment) for management of type IV thoracoabdominal aneurysm. Vascular, 2005; 13(2): 124–128.

19. Fulton, J. J., Farber, M. A., Marston, W. A., Mendes, R., Mauro, M. A., Keagy, B. A. Endovascular stent-graft repair of pararenal type IV thoracoabdominal aortic aneurysms with adjunctive visceral reconstruction. J. Vasc. Surg., 2005; 41(2): 191–198.

20. Černá, M., Köcher, M., Utíkal, P., Koutná, J., Benýšek, V., Bučil, J., Heřman, M., Bachleda, P., Dráč, P. Upravený protokol sledování nemocných po endovaskulární léčbě aneuryzmatu abdominální aorty, jeho zhodnocení ve vztahu k výsledkům. Čes. Radiol., 2006; 60(3): 134–139.

21. Gawenda, M., Aleksic, M., Heckenkamp, J., Reichert, V., Grossmann, A., Brunkwall, J. Hybrid-procedures for the treatment of thoracoabdominal aortic aneurysms and dissections. Eur. J. Vas. Endovasc. Surg., 2007; 33: 71–77.

22. Greco, F., Deriu, G. P., Stramana, R., Frigatti, P., Ragazzi, R. Type IV Thoraco-abdominal aortic aneurysm (TAAA IV) with occlusion of celiac and superior mesenteric arteries in high risk patient: successful treatment with a hybrid traditional vascular and endovascular procedure. Eur. J. Vasc. Endovasc. Surg. Extra, 2005; 9(5): 87–89.

23. Tachibana, K., Morishita, K., Kurimoto, Y., Fukada, J., Hachiro, Y., Abe, T. Endovascular stent-grafting for thoracoabdominal aortic aneurysm following bypass grafting to superior mesenteric and coeliac arteries: repot of two cases. Ann. Thorac. Cardiovasc. Surg., 2005; 11(5): 335–338.

24. Gregorie, I. D., Gupta, K., Jakobs, M.J., Poglajen, G., Suvorov, N., Dougherty, K. G., Krajcer, Z. Endovascular exclusion of a thoracoabdominal aortic aneurysm after retrograde visceral artery revascularisation. Tex. Heart. Inst. J., 2005; 32(2): 416–420.

25. Moawad, J., McKinsey, J. F., Wyble, C. W., Bassiouny, H. S., Schwartz, L. B., Gewertz, B. L. Current results of surgical therapy for chronic mesenteric ischemia. Arch. Surg., 1997; 132(6): 613–619.

26. Johnston, K. W., Lindsay, T. F., Walker, P. M., Kalman, P. G. Mesenteric arterial bypass grafts: Early and late results and suggested surgical approach for chronic and acute mesenteric ischemia. Surgery, 1995; 118(1): 1–7.

27. McMillan, W., McCarthy, W., Bresticker, M., et al. Mesenteric artery bypass: Objective patency determination. J. Vasc. Surg., 1995; 21: 729–741.

28. Shanley, C., Ozaki, C., Zelenock, G. Bypass grafting for chronic mesenteric ischemia. Surg. Clin. North. Am., 1997; 77: 381–395.

29. Pary, P .S., Darling, R. C., Lee, D., Chang, B. B., Roddy, S. P., Kreienberg, P. B., et al. Is prosthetic renal artery reconstruction a durable procedure? Ananalysis of 489 bypass grafts. J. Vasc. Surg., 2001; 34: 127–132.

30. Reilly, J. M., Rubin, B. G., Thompson, R. W., Allen, B.T., Anderson, C .B., Sicard, G. A. Long term effectiveness of extraanatomic renal artery revascularisation. Surgery, 1994; 116: 784–790.

31. Cormier, J. M., Fichelle, J. M., Laudan, C., Gigou, F., Artru, B., Ricco, J. B. Renal artery revascularisation with polytetrafluorethylene bypass graft. Ann. Vasc. Surg., 1991; 5: 133–137.

32. May, J., White, G. N., Yu, W., Waugh, R., Harris, J. P. Treatment of complex abdominal aortic aneurysms by a combination of endoluminal and extraluminal aortofemoral grafts. J. Vasc. Surg., 1994; 19: 924–933.

33. White, G. H., May, J., McGahan, T., Yu, W., Waugh, R. C., Stephen, M. S., Harris, J. P. Historic control comparison of outcome for matched groups of patients undergoing endoluminal versus open repair of abdominal aortic aneurysms. J. Vasc. Surg., 1996; 23: 201–212.

34. Lawrence-Brown, M., Sieunarine, K., van Schie, G., Purchas, S., Hartley, D., Goodman, M. A., Prendergast, F. J., Semmens, J. B. Hybrid open –endoluminal technique for repair of thoracoabdominal aneurysm involving the celiac axis. J. Endovasc. Ther., 2000; 7: 513–519.

35. Utíkal, P., Köcher, M., Bachleda, P., Dráč, P., Černá, M., Buriánková, E. Banding in aortic stent-graft fixation in EVAR. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc, 2004; 148(2): 175–178.

36. Inoue, K., Iwase, T., Sato, M., et al. Transluminal endovascular branched graft placement for a pseudoaneurysm: reconstruction of the descending thoracic aorta including the coeliac axis. J. Thorac. Cardiovasc. Surg., 1997; 114: 859–861.

37. Kinney, E. V., Kaebnick, H. W., Mitchell, R. A., Jung, M. T. Repair of mycotic paravisceral aneurysm with a fenestrated stent-graft. J. Endovasc. Ther., 2000; 7: 192–197.

38. Hosokawa, H., Iwase, T., Sato, M., Yoshida, Y., Oeno, K., Tamaki, S., Inoue, K. Successful endovascular repair of juxtarenal and suprarenal aortic aneurysms with a branched stent graft. J. Vasc. Surg., 2001; 33(5): 1087–1092.

39. Vos, A. W. F., Linsen, M. A. M., Wisselink, W., Rauwerda, J. A. Endovascular grafting of complex aortic aneurysms with a modular side branch stent-graft system in a porcine model. Eur. J. Vasc. Endovasc. Surg., 2004; 27: 492–497.

40. Anderson, J. L., Adam, D. J., Berce, M., Hartley, D. E. Repair of thoracoabdominal aortic aneurysms with fenestrated and branched endovascular stent grafts. J. Vasc. Surg., 2005; 42(4): 600–607.

Labels
Surgery Orthopaedics Trauma surgery

Article was published in

Perspectives in Surgery

Issue 1

2010 Issue 1

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#