tailieunhanh - Báo cáo y học: "Failed surgical ligation of the proximal left subclavian artery during hybrid thoracic endovascular aortic repair successfully managed by percutaneous plug or coil occlusion: a report of 3 cases"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Failed surgical ligation of the proximal left subclavian artery during hybrid thoracic endovascular aortic repair successfully managed by percutaneous plug or coil occlusion: a report of 3 cases. | Maleux et al. Journal of Cardiothoracic Surgery 2011 6 45 http content 6 1 45 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Failed surgical ligation of the proximal left subclavian artery during hybrid thoracic endovascular aortic repair successfully managed by percutaneous plug or coil occlusion a report of 3 cases Geert Maleux Johan Vaninbroukx and Sam Heye Abstract Open surgical rerouting and proximal ligation of one or more supra-aortic vessels prior to endovascular stent-graft placement has become an alternative to major open thoracic surgery in the treatment of complex thoracic aortic disease. Complications owing to failed surgical ligation of the left subclavian artery are rare. In this report 3 cases of failed ligation are presented. Diagnosis was made by CT-scan and treatment was performed by transcatheter coil and plug embolization avoiding redo neck surgery. Background Endovascular repair has become a valuable alternative to open repair for the treatment of several thoracic aortic pathologies 1-4 . However stent-graft placement requires an adequate proximal and distal landing zone in the aorta of at least 2 cm in order to avoid early or late type I endoleak. Therefore surgical ligation and rerouting of one or more supra-aortic vessels can be necessary for safe stent-graft deployment and efficient and durable clinical outcome. Recent reports deal with the successful technical and clinical outcome after supra-aortic rerouting 5-7 . However type and management of complications related to this type of open vascular surgery are scarce and not well-documented 7 . In this report we present the clinical and radiological outcome after endovascular management of failed surgical ligation of the left subclavian artery during supra-aortic rerouting for safe thoracic stent-graft placement. From 1999 to end of 2009 172 thoracic stent-graft procedures in 160 patients were performed in the author s institution. In 49 .