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Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Coil Embolization-Assisted Thoracic Endovascular Aortic Repair for Multiple Saccular Descending Aortic Aneurysms with
Akito Imai1, Tomomi Nakajima1, Masataka Sato1
1Department of Cardiovascular Surgery, Hitachi General Hospital, Ibaraki, Japan.
Insights
A novel coil embolization technique aids thoracic endovascular aortic repair for challenging saccular aneurysms. This method secures adequate landing zones, potentially expanding treatment options for complex aortic conditions.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Background:
- Thoracic endovascular aortic repair (TEVAR) is a minimally invasive treatment for thoracic aortic aneurysms.
- Saccular aneurysms, particularly those near critical visceral arteries, present challenges due to inadequate proximal or distal landing zones.
Observation:
- A 74-year-old male patient presented with multiple saccular descending aortic aneurysms.
- The distalmost aneurysm was located at the celiac trunk level, with only 10 mm between it and the superior mesenteric artery, creating a compromised landing zone.
Findings:
- A coil embolization-assisted TEVAR technique was successfully employed.
- Coil embolization of the distal saccular aneurysm created a sufficient landing zone prior to stent graft deployment.
- Postoperative computed tomography confirmed accurate device placement and absence of endoleak.
Implications:
- This coil embolization-assisted TEVAR approach may broaden the applicability of endovascular repair for saccular aneurysms with insufficient landing zones.
- It offers a potential solution for complex aortic pathologies previously considered unsuitable for standard TEVAR.
- This technique could improve outcomes and reduce the need for open surgical repair in select patient populations.
Abstract:
We report a coil embolization-assisted thoracic endovascular aortic repair technique successfully applied to multiple saccular descending aortic aneurysms in a 74-year-old man. Because of the most distal aneurysm being located at the celiac trunk level and the distance between the superior mesenteric artery and the aneurysm being only 10 mm, a coil embolization of the distal saccular aneurysm was performed before stent delivery to secure a sufficient landing zone. Postoperative computed tomography showed an appropriate positioning of the endovascular devices without endoleak. This coil embolization-assisted technique may extend the indication of the endovascular aortic repair when a saccular aneurysm has an insufficient landing zone.
