Related Experiment Video
Updated: Aug 25, 2025
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Totally Percutaneous Repair of an Aortic Arch Dissection: A Case Report
Eduardo Keller Saadi1,2,3,4, Ana Paula Tagliari1,2,4, Rodrigo Petersen Saadi1,3
1Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Insights
This study shows a totally percutaneous aortic arch repair is feasible for complex aneurysms. Careful planning and a skilled team are crucial for this challenging endovascular intervention.
Area of Science:
- Cardiovascular Surgery
- Vascular Endovascular Intervention
- Aortic Aneurysm Repair
Background:
- Endovascular repair is standard for descending thoracic aorta diseases.
- Its application in ascending aorta and arch pathologies remains less established.
- Complex aortic arch aneurysms pose significant surgical challenges.
Observation:
- A 71-year-old male with a history of open ascending aorta replacement presented with a large dissected aortic arch aneurysm.
- Vascular access was achieved via ultrasound-guided punctures.
- Aortic arch exclusion was performed using endoprostheses with the chimney-graft technique to maintain supra-aortic branch flow.
Findings:
- The case demonstrates the successful feasibility of a totally percutaneous aortic arch repair.
- This challenging intervention required meticulous preprocedural planning.
- A dedicated, experienced surgical team was essential for execution.
Implications:
- This approach offers a less invasive alternative for complex aortic arch pathologies.
- Highlights the potential of endovascular techniques for previously open-repair-only conditions.
- Emphasizes the importance of advanced planning and specialized teams for complex aortic interventions.
Abstract:
Although the endovascular repair of descending thoracic aorta diseases is an already consolidated procedure, this approach is not well-established for ascending aorta and arch pathologies. A 71-year-old male patient who had undergone an open ascending aorta replacement ten years ago presented with a huge dissected aortic arch aneurysm. Vascular accesses were obtained with ultrasound-guided punctures, followed by aortic arch exclusion using aortic endoprostheses and the chimney-graft technique for preserving supra-aortic branches flow. This case demonstrates the feasibility of a totally percutaneous aortic arch repair provided that careful preprocedural planning and a dedicated team are available for such a challenging intervention.
