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Endovascular repair for concomitant multilevel aortic disease
Patrizio Castelli1, Roberto Caronno, Gabriele Piffaretti
1Postgraduate School in Vascular Surgery-Department of Surgery, University of Insubria, Ospedale di Circolo, 21100 viale Borri 57, Varese, Italy.
Summary
Endovascular repair for simultaneous thoracic and abdominal aortic disease is a feasible option for high-risk patients. This approach offers a viable alternative to conventional surgery for complex multilevel aortic disease.
Area of Science:
- Cardiovascular Surgery
- Vascular Endovascular Therapy
- Aortic Disease Management
Background:
- Multilevel aortic disease poses significant surgical challenges and risks.
- A small subgroup of patients requires extensive treatment for both thoracic and abdominal aorta.
Purpose of the Study:
- To evaluate the feasibility and outcomes of simultaneous endovascular repair for thoracic and abdominal aortic disease.
- To present the experience with endovascular exclusion in four high-risk patients.
Main Methods:
- Four patients with simultaneous thoracic and abdominal aortic disease underwent endovascular repair between 2002 and 2005.
- Procedures involved thoracic stent-grafts (Excluder/TAG, Talent) and abdominal stent-grafts (Excluder, Zenith).
- Follow-up included CT-angiography and chest X-rays at regular intervals.
Main Results:
- Technical success was achieved in all cases with no intraoperative mortality.
- One patient experienced early postoperative acute renal failure, managed without dialysis.
- One late death occurred due to a thoracic endoleak; three survivors remain well with no neurological complications.
Conclusions:
- Simultaneous endovascular repair for multilevel aortic disease is feasible.
- This approach offers a viable alternative for high-risk patients unsuitable for conventional repair.