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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2016 August;57(4):540-2

lingua: Inglese

Systematic cervical approach for endovascular treatment of thoracic aortic diseases with debranching

Yannick GEORG, Adeline SCHWEIN, Anne LEJAY, Benoit LUCEREAU, Fabien THAVEAU, Nabil CHAKFE

Department of Vascular Surgery, University Hospital of Strasbourg, France


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Endovascular treatment of thoracic aorta (TEVAR) often requires supra-aortic arterial trunks debranching to provide an acceptable proximal landing zone. To facilitate TEVAR procedures involving landing zones 1 to 3, we propose a systematic 4-step strategy with 1) a primary surgical cervical exposure of the supra-aortic trunks; 2) insertion through this access of a 5 Fr introducer in the first non-covered supra-aortic trunk to delineate precisely the landing zone; 3) followed by deployment of the thoracic endograft through one femoral access; 4) immediate completion of the surgical debranching, i.e. transposition or bypass.

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nabil.chakfe@chru-strasbourg.fr