Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Hybrid Endovascular Repair of Thoracoabdominal Aortic Aneurysm Using Visceral Debranching Technique - 2 case reports-

내장동맥 탈분지술과 혈관내 교정 하이브리드 술식으로 치료한 흉복부대동맥류 치험 - 2예 보고 -

  • Kim, Jong-Woo (Department of Thoracic and Cardiovascular Surgery, Institute of Health Science, Gyeongsang National University) ;
  • Choi, Jun-Young (Department of Thoracic and Cardiovascular Surgery, Institute of Health Science, Gyeongsang National University) ;
  • Rhie, Sang-Ho (Department of Thoracic and Cardiovascular Surgery, Institute of Health Science, Gyeongsang National University) ;
  • Jang, In-Seok (Department of Thoracic and Cardiovascular Surgery, Institute of Health Science, Gyeongsang National University) ;
  • Sim, Hee-Jae (Department of Thoracic and Cardiovascular Surgery, Institute of Health Science, Gyeongsang National University) ;
  • Shin, Tae-Beom (Department of Radiology, Gyeongsang National University Hospital)
  • 김종우 (경상대학교 의과대학 흉부외과학교실, 경상대학교 건강과학 연구원) ;
  • 최준영 (경상대학교 의과대학 흉부외과학교실, 경상대학교 건강과학 연구원) ;
  • 이상호 (경상대학교 의과대학 흉부외과학교실, 경상대학교 건강과학 연구원) ;
  • 장인석 (경상대학교 의과대학 흉부외과학교실, 경상대학교 건강과학 연구원) ;
  • 심희제 (경상대학교 의과대학 흉부외과학교실, 경상대학교 건강과학 연구원) ;
  • 신태범 (경상대학교병원 영상의학과)
  • Received : 2010.09.29
  • Accepted : 2010.11.12
  • Published : 2010.12.05
Download PDF
⟨ Previous Next ⟩

Abstract

Surgical repair of thoracoabdominal aortic aneurysm (TAAA) remains a formidable challenge associated with significant rates of mortality and morbidity, especially in patients with high risk. Use of endovascular stent graff in aortic aneurysm disease is now accepted as an alternative treatment to surgery. But the saving of visceral arteries is the chief obstacle to endovascular repair of TAAA. We successfully treated two patients of TAAA with high risk by hybrid procedure including open visceral debranching and concomitant endovascular aneurysm exclusion.

흉복부대동맥류 질환에서 고전적인 수술은 고위험군 환자에서 아직까지 높은 합병증 발생과 사망률을 나타낸다. 최근에는 스텐트 그라프트를 이용한 혈관내 시술(endovascular repair)이 시행되고 있으나 내장동맥의 보존이 시술의 걸림돌이 되고 있다. 저자들은 2명의 고위험군 흉복부대동맥류 환자에서 내장동맥 우회술과 흉복부대동맥에 스벤트 그라프트를 삽입하는 하이브리드 술식을 이용하여 성공적으로 치료하였다.

Keywords

References

  1. Coselli JS, LeMaire SA, Miller 3rd CC, et al. Mortality and paraplegia after thoracoabdominal aortic aneurysm repair: a risk factor analysis. Ann Thorac Surg 2000;69:409-14. https://doi.org/10.1016/S0003-4975(99)01478-2
  2. Bavaria JE, Appoo JJ, Makaroun MS, et al. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg 2007;133:369-77. https://doi.org/10.1016/j.jtcvs.2006.07.040
  3. Svensson LG, Kouchoukos NT, Miller DC. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 2008;85:S1-41. https://doi.org/10.1016/j.athoracsur.2007.10.099
  4. Hughes GC, Nienaber JJ, Bush EL, Daneshmand MA, McCann RL. Use of custom Dacron branch grafts for "hybrid" aortic debranching during endovascular repair of thoracic and thoracoabdominal aortic aneurysms. J Thorac Cardiovasc Surg 2008;136:21-8. https://doi.org/10.1016/j.jtcvs.2008.02.051
  5. Drinkwater SL, Bockler D, Eckstein H, et al. The visceral hybrid repair of thoraco-abdominal aortic aneurysms -a collaborative approach. Eur J Vasc Endovasc Surg 2009;38: 578-85. https://doi.org/10.1016/j.ejvs.2009.07.002
  6. Roselli EE, Greenberg RK, Pfaff K, et al. Endovascular treatment of thoracoabdominal aortic aneurysms. J Thorac Cardiovasc Surg 2007;133:1474-82. https://doi.org/10.1016/j.jtcvs.2006.09.118
  7. Chiesa R, Tshomba Y, Melissano G, Logaldo D. Is hybrid procedure the best treatment option for thoraco-abdominal aortic aneurysm? Eur J Vasc Endovasc Surg 2009;38:26-34. https://doi.org/10.1016/j.ejvs.2009.03.018
  8. Kuratani T, Kato M, Shirakawa Y, Shimamura K, Sawa Y. Long-term results of hybrid endovascular repair for thoraco- abdominal aortic aneurysms. Eur J Cardiothorac Surg 2010; 38:299-304. https://doi.org/10.1016/j.ejcts.2010.02.013