Extensive complex thoracoabdominal aortic aneurysm salvaged by surgical graft providing landing zone for endovascular graft: A case report

doi:10.12998/wjcc.v10.i15.5005

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 10, Issue 15

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (4933)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-3) series.

Item

Count

PDF

287

WORD

HTML

2244

Figures (1-3)

747

Sum=3339

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

407

Download

1168

Sum=1575

May 26, 2022 (publication date) through Mar 3, 2026

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Clinical Cases

ISSN

2307-8960

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article with Cover (PDF)
- Full Article (XML)

Case Report

World J Clin Cases. May 26, 2022; 10(15): 5005-5011
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.5005

Extensive complex thoracoabdominal aortic aneurysm salvaged by surgical graft providing landing zone for endovascular graft: A case report

Albert Youngwoo Jang, Pyung Chun Oh, Jin Mo Kang, Chul Hyun Park, Woong Chol Kang

Albert Youngwoo Jang, Department of Cardiology, Gachon University Gil Medical Center, Incheon 1198, South Korea

Pyung Chun Oh, Department of Internal Medicine, Gil Medical Center, Gachon Cardiovascular Research Institute, Gachon University College of Medicine, Incheon 1198, South Korea

Jin Mo Kang, Division of Vascular Surgery, Gachon University Gil Medical Center, Incheon 1198, South Korea

Chul Hyun Park, Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Incheon 1198, South Korea

Woong Chol Kang, Division of Cardiology, Gil Medical Center, Gachon University of Medicine and Science, Incheon 1198, South Korea

Author contributions: Jang AY and Kang WC were the patient’s interventionists, reviewed the literature and contributed to manuscript drafting, writing, editing, and revising; Oh PC, Kang JM, and Park CH were interventionists or surgeons of the patient, who reviewed and edited the manuscript; all authors issued final approval for the version to be submitted.

Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Woong Chol Kang, MD, PhD, Professor, Division of Cardiology, Gil Medical Center, Gachon University of Medicine and Science, 783 Namdong-daero, Incheon 1198, South Korea. kangwch@gilhospital.com

Received: November 6, 2021
Peer-review started: November 6, 2021
First decision: December 27, 2021
Revised: January 7, 2022
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 26, 2022
Processing time: 199 Days and 13.2 Hours

Abstract

BACKGROUND

Surgical repair of complex abdominal aortic aneurysm is associated with a higher perioperative mortality and morbidity. The advent of endovascular aortic repair (EVAR) has reduced perioperative complications, although the utilization of such techniques is limited by lesion characteristics, such as involvement of the visceral or renal arteries (RA) and/or presence of a sealing zone.

CASE SUMMARY

A 60-year-old male presented with a Crawford type IV complex thoracoabdominal aortic aneurysm (CAAA) starting directly distal to the diaphragm extending to both common iliac arteries (CIAs). The CAAA consist of a proximal and distal aneurysmal sac separated by a 1 cm-healthy zone in the infrarenal level. Due to the poor performance of the patient and the expansive disease, we planned a stepwise-combined surgery and EVAR to minimize invasiveness. A branched graft was implanted after surgical debranching of the visceral and RA. Since the patient had renal and liver injury after surgery, the second stage EVAR was performed 10 mo later. The stent graft was implanted from the distal portion of surgical branched graft to both CIAs during EVAR. The patient has been uneventful for 5-years after discharge and is being followed in the outpatient clinic.

CONCLUSION

The current case demonstrates that the surgical graft can provide a landing zone for second stage EVAR to avoid aggressive surgery in patients with poor performance with a long hostile CAAA.

Keywords: Complex thoracoabdominal aortic aneurysm; Abdominal aortic aneurysm surgery; Endovascular aortic repair; Common iliac artery aneurysm; Case report

Core Tip: Complex thoracoabdominal aortic aneurysm (CAAA) is an aortic disease requiring aggressive surgery. Herein, we report a case where branched graft was implanted covering half of the aortic disease, followed by a stent graft inserted through endovascular aortic repair to minimize invasiveness in a patient with extensive CAAA.