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Endovascular repair of extent I thoracoabdominal aneurysms with landing zone extension into the aortic arch and mesenteric portion of the abdominal aorta 

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Presentation on theme: "Endovascular repair of extent I thoracoabdominal aneurysms with landing zone extension into the aortic arch and mesenteric portion of the abdominal aorta "— Presentation transcript:

1 Endovascular repair of extent I thoracoabdominal aneurysms with landing zone extension into the aortic arch and mesenteric portion of the abdominal aorta  Clayton J. Brinster, MD, Wilson Y. Szeto, MD, Joseph E. Bavaria, MD, Edward Y. Woo, MD, Ronald M. Fairman, MD, Benjamin M. Jackson, MD  Journal of Vascular Surgery  Volume 52, Issue 2, Pages (August 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Three-dimensional reconstructions of a computed tomography angiogram using M2S software (West Lebanon, NH) show an extent I thoracoabdominal aortic aneurysm (A) preoperatively and (B) after thoracic endovascular aneurysm repair. Note the landing zone extension to include coverage of the left subclavian artery (white arrow) proximally and the celiac artery (yellow arrow) distally. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 A, A predeployment aortogram shows the proximal extent of the thoracoabdominal aortic aneurysm. B, The postdeployment aortogram shows landing zone extension into the aortic arch with a patent left subclavian artery (LSA) bypass (arrow). C, The completion angiogram after thoracic endovascular aneurysm repair and proximal LSA coiling shows aneurysmal exclusion without endoleak; note the patent LSA bypass and antegrade distal LSA perfusion (arrow). D, The proximal LSA has been coil embolized through brachial artery access to prevent type II endoleak. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

4 Fig 3 A, The distal extent of the thoracoabdominal aortic aneurysm is shown in this predeployment angiogram. B, An early-phase postdeployment lateral angiogram shows celiac artery coverage and antegrade superior mesenteric artery (SMA) perfusion. C, A late-phase postdeployment lateral angiogram shows antegrade SMA perfusion and subsequent retrograde filling of the celiac axis. D, Collateral filling of the hepatic and splenic arteries (arrows) can be seen in this anteroposterior view of the postdeployment completion angiogram. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

5 Fig 4 A, A computed tomography angiogram reconstruction using M2S software (West Lebanon, NH) shows a distal type I endoleak (arrow) after the initial thoracic endovascular aneurysm repair, including celiac artery coverage. B, Antegrade superior mesenteric artery perfusion (black arrow) is evident in this angiogram, which also demonstrates a distal type I endoleak (white arrow) in the patient from Panel A. C, An angiogram shows distal sealing and aneurysmal exclusion after reintervention. D, An M2S reconstruction of a postreintervention computed tomography angiogram note the absence of endoleak. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

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