Endovascular Management of Aortic Dissections Involving the Common Carotid and Subclavian Arteries

• Authors: Mirosław Wąsiewicz , Anna Kasielska-Trojan , Dariusz Timler , Mirosław Stelągowski
• Languages of publication: EN

Abstracts

EN

Aortic dissection is a life-threatening condition, in which rupture of the internal wall of the aorta is observed. The aim of the study was to present the techniques used in patients with type A Stanford aortic dissection treatment by means of carotid-carotid by-pass surgery and implantation of the aortic stent-graft with intentional occlusion of the left common carotid and subclavian arteries. Surgical methods were presented on the basis of three patients treated at the Department of Vascular, General and Oncological Surgery, Memorial Copernicus Hospital in Łódź. Different carotid- carotid bypass grafting techniques were also described. Our own clinical observations demonstrated that patients with retro-pharyngeal carotid-carotid bypass did not report dysphagia, and retropharyngeal grafting seems to be the optimal method considering patients in whom stent-grafts cause left carotid artery occlusion.

Keywords

EN

aortic dissection; stent-graft; carotid-carotid by-pass

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 2
• Pages: 90-95

Dates

published

1 - 02 - 2013

online

22 - 03 - 2013

Contributors

author

Mirosław Wąsiewicz

• Department of the Vascular, General and Oncologic Surgery, Memorial Copernicus Hospital in Łódź

author

Anna Kasielska-Trojan

• Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University in Łódź

author

Dariusz Timler

• Department of Emergency Medicine and Disaster Medicine, Medical University in Łódź

author

Mirosław Stelągowski

• Department of the Vascular, General and Oncologic Surgery, Memorial Copernicus Hospital in Łódź

References

• 1. Lansman SL , McCullough JN , Nguyen KH et al.: Subtypes of acute aortic dissection. Ann ThoracSurg 1999; 67: 1975-80.
• 2. Creager MA, Dzau VCJ , Loscalzo J: Choroby naczyń. Wydawnictwo Czelej, 2008; 587-602.
• 3. Jacuzzi Jl, Sabatine MS, Eagle KA et al.: Iatrogenic aortic dissection. Am J Cardiol 2002; 89: 623-26.
• 4. Yeh CH , Chen MC, Wu YC et al.: Risk factors for descending aortic aneurysm formation in medium term follow-up of patients with type A aortic dissection. Chest 2003; 124: 989-95.
• 5. Takahara Y, Sudo Y, Mogi K et al.: Total aortic arch grafting for acute type A dissection: analysis of residual false lumen. Ann Thorac Surg 2002; 73: 450-54.
• 6. Kazui T, Washiyama N, Muhammad BA et al.: Extended total arch replacement for acute type A aortic dissection: experience with seventy patients. J Thorac Cardiovasc Surg 2000; 119: 558-65.
• 7. Hirotani T, Nakamichi T, Munakata M et al.: Routine extended graft replacement for an acute type A aortic dissection and the patency of the residual false channel. Ann Thorac Surg 2003; 76: 1957-61.
• 8. Urbański PP, Siebel A, Zacher M et al.: Is extended aortic replacement in acute type A dissection justifiable? Ann Thorac Surg 2003; 75: 525-29.
• 9. Massimo CG, Presenti LF , Marranci P et al.: Extended and total aortic resection in the surgical treatment of acute type A aortic dissection: experience with 54 patients. Ann Thorac Surg 1988; 46: 420-424.
• 10. Minale C, Splittgerber FH , Reifschneider HJ : Replacement of the entire thoracic aorta in a single stage. Ann Thorac Surg 1994; 57: 850-55.
• 11. Crawford ES , Kirklin JW, Naftel DC et al.: Surgery for acute dissection of ascending aorta. Should the arch be included? J Thorac CardiovascSurg 1992; 104: 46-59.
• 12. Sueyoshi E, Sakamoto I, Hayashi K et al.: Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase. Circulation 2004; 110: II256-61.
• 13. Kato M, Ohnishi K, Kaneko M et al.: New graft- implanting method for thoracic aortic aneurysm or dissection with a stented graft. Circulation 1996; 94(suppl): II-188 -II-193.
• 14. Kato M, Matsuda T, Kaneko M et al.: Outcomes of stent-graft treatment of false lumen in aortic dissection. Circulation 1998; 98(suppl): II-305-II-312.
• 15. Shimamura K, Kuratani T, Matsumiya G et al.: Long-term results of the open stent-grafting technique for extended aortic arch disease. J ThoracCardiovasc Surg 2008; 135: 1261-69.
• 16. Uchida N, Ishihara H, Shibamura H et al.: Midterm results of extensive primary repair of the thoracic aorta by means of total arch replacement with open stent graft placement for an acute type A aortic dissection. J Thorac Cardiovasc Surg 2006; 131: 862-67.
• 17. Svensson LG, Kouchoukos NT , Miller DC et al.: Society of Thoracic Surgeons Endovascular Surgery Task Force. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 2008; 85(1, Suppl): S1-S41
• 18. DiMusto PD, Williams DM, Patel HJ et al.: Endovascular management of type B aortic dissections. J Vasc Surg 2010; 52(4, Suppl): 26S-36S[PubMed][Crossref]
• 19. Janczak D, Skóra J, Garcarek J i wsp.: Własne doświadczenia w leczeniu zespołu ostrego rozwarstwienia aorty typu B. Pol Przegl Chir 2012; 84: 38-50.
• 20. Chen LW, Dai XF, Lu L et al.: Extensive primary repair of the thoracic aorta in acute type A aortic dissection by means of ascending aorta replacement combined with open placement of triple-branched stent graft: early results. Circulation 2010; 122: 1373-78.[WoS]
• 21. Bortone AS , Schena S, Mannatrizio G et al.: Endovascular stent-graft treatment for diseases of the descending thoracic aorta. Eur J CardiothoracSurg 2001; 20: 514-19.
• 22. Riesenman PJ, Farber MA, Mendes RR et al.: Coverage of the left subclavian artery during thoracic endovascular aortic repair. J Vasc Surg 2007; 45: 90-95.
• 23. Rehders TC , Petzsch M, Ince H et al.: Nienaber CA Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta: risk and relevance. J Endovasc Ther 2004; 11: 659-66.
• 24. Riesenman PJ, Tamaddon HS , Farber MA: Surgical by-pass procedures to facilitate endovascular repair of aortic arch pathology. J CardiovascSurg (Torino) 2008; 49: 461-69.
• 25. T racci MC, Cherry KJ : Leczenie chirurgiczne chorych z niedrożnością tętnic odchodzących od łuku aorty. Chirurgia po dyplomie 2010; 4: 44-55.

Identifiers

DOI

10.2478/pjs-2013-0016