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Challenging endovascular treatment of a thoracic saccular aneurysm in extensive coral reef aorta

Toru Ide1, Kenta Masada2, Toru Kuratani3

  • 1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

Journal of Vascular Surgery Cases and Innovative Techniques
|October 17, 2022
PubMed

Insights

Thoracic endovascular aortic repair (TEVAR) successfully treated a saccular aneurysm in coral reef aorta (CRA), a challenging condition due to severe aortic calcification. This case demonstrates TEVAR

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coral reef aorta (CRA) presents with severe aortic calcification and obstructive lesions.
  • Thoracic endovascular aortic repair (TEVAR) is a minimally invasive option for aortic diseases.
  • Saccular aneurysms in CRA are rarely treated with TEVAR, with open surgery being more common.

Observation:

  • A 72-year-old frail patient presented with a descending thoracic saccular aneurysm within CRA.
  • The patient's aorta exhibited severe calcification, posing a significant challenge for endovascular procedures.

Findings:

  • TEVAR was performed to exclude the saccular aneurysm in the severely calcified aorta.
  • Advancement of the stent graft system was difficult due to aortic calcification.
  • Successful exclusion of the aneurysm was achieved despite the technical challenges.

Implications:

  • TEVAR can be a viable treatment option for saccular aneurysms in patients with coral reef aorta.
  • This case highlights the feasibility of TEVAR in complex aortic anatomies.
  • Further research may explore expanded indications for TEVAR in calcified aortic diseases.

Keywords:
Bypass graftingCoral reef aortaSaccular aneurysmThoracic aneurysmThoracic endovascular aortic repair

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