PURPOSE: Anastomotic pseudoaneurysm is a rare but life-threatening complication after thoracic aortic surgery. Endovascular stent-grafting is a less invasive treatment for thoracic aortic aneurysm; however, its clinical usefulness for anastomotic pseudoaneurysms following thoracic aortic surgery is unclear. METHODS: A series of 12 anastomotic pseudoaneurysms in 10 patients, which occurred following thoracic aortic surgery, underwent endovascular stent-grafting in our university hospital. Eight emergent endovascular stent-grafting cases were included in this study. A hand-made stent-graft, reconstructed by suturing graft material to an endoskeleton of modified Gianturco Z stents, was used in all cases. RESULTS: The delivery success rate was 91.7%, and the hospital mortality rate was 25.0%. Two cases were converted to open surgery during the postoperative phase because of a type I endoleak. Complete absorption or shrinkage of the anastomotic pseudoaneurysm was observed in seven of nine cases. CONCLUSION: Endovascular stent-grafting for patients with anastomotic pseudoaneurysms of the thoracic aorta following thoracic aortic surgery has become a possible optimal treatment. However, long-term outcome remains unclear, and periodical follow-up is required.
PURPOSE:Anastomotic pseudoaneurysm is a rare but life-threatening complication after thoracic aortic surgery. Endovascular stent-grafting is a less invasive treatment for thoracic aortic aneurysm; however, its clinical usefulness for anastomotic pseudoaneurysms following thoracic aortic surgery is unclear. METHODS: A series of 12 anastomotic pseudoaneurysms in 10 patients, which occurred following thoracic aortic surgery, underwent endovascular stent-grafting in our university hospital. Eight emergent endovascular stent-grafting cases were included in this study. A hand-made stent-graft, reconstructed by suturing graft material to an endoskeleton of modified Gianturco Z stents, was used in all cases. RESULTS: The delivery success rate was 91.7%, and the hospital mortality rate was 25.0%. Two cases were converted to open surgery during the postoperative phase because of a type I endoleak. Complete absorption or shrinkage of the anastomotic pseudoaneurysm was observed in seven of nine cases. CONCLUSION: Endovascular stent-grafting for patients with anastomotic pseudoaneurysms of the thoracic aorta following thoracic aortic surgery has become a possible optimal treatment. However, long-term outcome remains unclear, and periodical follow-up is required.
Authors: Martin Czerny; Michael Grimm; Daniel Zimpfer; Suzanne Rodler; Roman Gottardi; Doris Hutschala; Johannes Lammer; Ernst Wolner; Maria Schoder Journal: Ann Thorac Surg Date: 2007-02 Impact factor: 4.330
Authors: Paul J Riesenman; Mark A Farber; Robert R Mendes; William A Marston; Joseph J Fulton; Matthew Mauro; Blair A Keagy Journal: J Vasc Surg Date: 2005-12 Impact factor: 4.268
Authors: Fang Hong Chen; Won Heum Shim; Byung Chul Chang; Sang Joon Park; Jong Yun Won; Do Yun Lee Journal: J Endovasc Ther Date: 2003-04 Impact factor: 3.487
Authors: Grayson H Wheatley; Anthony Nunez; Ourania Preventza; Venkatesh G Ramaiah; Julio A Rodriguez-Lopez; James Williams; Dawn Olsen; Edward B Diethrich Journal: J Thorac Cardiovasc Surg Date: 2007-03-28 Impact factor: 5.209