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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2016 October;57(5):646-52

lingua: Inglese

Branched stent-grafts deployed in the true and false lumen to exclude a post dissecting thoracoabdominal aneurysm

Luca BERTOGLIO 1, Enrico M. MARONE 1, Efrem CIVILINI 2, Tommaso CAMBIAGHI 1, Daniele MASCIA 1, Roberto CHIESA 1

1 Department of Vascular Surgery, Scientific Institute San Raffaele Hospital, Vita Salute San Raffaele University, Milan, Italy; 2 Humanitas Clinical and Research Center, Department of Vascular Surgery, Rozzano, Italy


The aim of this case report was to present an endovascular treatment of a residual post-dissection Crawford type III thoracoabdominal aneurysm (TAA). A 60-year-old man, who had suffered from acute type B aortic dissection (TBAD) 8 years ago and had already been treated for both descending thoracic and infrarenal aortic aneurysm with open repair, presented with a 61mm post-dissection TAA. The aneurysm was successfully excluded with a staged fully endovascular procedure by employing two multibranched custom-made stent grafts deployed into the false lumen. The first stent-graft with a proximal monobranch was created to perfuse the right renal artery via the true lumen. The latter, with a triple branch design, was meant to perfuse the visceral arteries and left renal artery arising from the false lumen. Available branched custom-made stent-grafts for the treatment of degenerative TAA can be employed also in post TBAD aneurysms so as to simplify the procedure. The branched stent-grafts could be deployed within an enlarged false lumen provided that a suitable distal landing zone is available as well as that the visceral vessels can be perfused from the false lumen. A proximal branch for perfusing one of the lumens of the dissection from the proximal tear can be an alternative solution to creating neofenestrations.

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