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Successful Repair of Type I Endoleak Using the Frozen Elephant Trunk Technique

  • Kim, Seon Hee (Department of Trauma Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National School of Medicine) ;
  • Song, Seunghwan (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National School of Medicine) ;
  • Kim, Sang-pil (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National School of Medicine) ;
  • Lee, Chung Won (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National School of Medicine) ;
  • Son, Joohyung (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National School of Medicine)
  • Received : 2015.08.17
  • Accepted : 2016.03.29
  • Published : 2016.08.05

Abstract

Thoracic endovascular aortic repair (TEVAR) has emerged as an effective therapy for a variety of thoracic aortic pathologies. However, various types of endoleak remain a major concern, and its treatment is often challenging. We report a case of type I endoleak occurring 19 months after zone II hybrid TEVAR. The endoleak was successfully repaired by the frozen elephant trunk technique, without removal of a previous stent graft, combined with ascending aorta and total arch replacement.

Keywords

References

  1. Dumfarth J, Michel M, Schmidli J, et al. Mechanisms of failure and outcome of secondary surgical interventions after thoracic endovascular aortic repair (TEVAR). Ann Thorac Surg 2011;91:1141-6. https://doi.org/10.1016/j.athoracsur.2010.12.033
  2. Szeto WY, Desai ND, Moeller P, et al. Reintervention for endograft failures after thoracic endovascular aortic repair. J Thorac Cardiovasc Surg 2013;145(3 Suppl):S165-70. https://doi.org/10.1016/j.jtcvs.2012.11.046
  3. Lee WA. Failure modes of thoracic endografts: prevention and management. J Vasc Surg 2009;49:792-9. https://doi.org/10.1016/j.jvs.2008.12.068
  4. Czerny M, Funovics M, Sodeck G, et al. Long-term results of thoracic endovascular aortic repair in atherosclerotic aneurysms involving the descending aorta. J Thorac Cardiovasc Surg 2010;140(6 Suppl):S179-84. https://doi.org/10.1016/j.jtcvs.2010.06.031
  5. Eggebrecht H, Thompson M, Rousseau H, et al. Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications. Circulation 2009;120(11 Suppl):S276-81. https://doi.org/10.1161/CIRCULATIONAHA.108.835926
  6. Ueda T, Fleischmann D, Dake MD, Rubin GD, Sze DY. Incomplete endograft apposition to the aortic arch: bird-beak configuration increases risk of endoleak formation after thoracic endovascular aortic repair. Radiology 2010;255:645-52. https://doi.org/10.1148/radiol.10091468
  7. Sze DY, Mitchell RS, Miller DC, et al. Infolding and collapse of thoracic endoprostheses: manifestations and treatment options. J Thorac Cardiovasc Surg 2009;138:324-33. https://doi.org/10.1016/j.jtcvs.2008.12.007
  8. Bavaria J, Milewski RK, Baker J, Moeller P, Szeto W, Pochettino A. Classic hybrid evolving approach to distal arch aneurysms: toward the zone zero solution. J Thorac Cardiovasc Surg 2010;140(6 Suppl):S77-80. https://doi.org/10.1016/j.jtcvs.2010.07.031
  9. Holubec T, Raupach J, Dominik J, Vojacek J. "Elephant trunk" and endovascular stentgrafting: a hybrid approach to the treatment of extensive thoracic aortic aneurysm. Acta Medica (Hradec Kralove) 2013;56:80-2. https://doi.org/10.14712/18059694.2014.28
  10. Kent WD, Manjunath A, Malaisrie SC. Frozen elephant trunk repair for descending thoracic aortic dissection in a man with a hostile left pleural cavity. Tex Heart Inst J 2014;41:341-3. https://doi.org/10.14503/THIJ-13-3369
  11. Watanabe Y, Shimamura K, Shirakawa Y, Torikai K, Kuratani T, Sawa Y. A new staged hybrid total arch repair procedure using a branched proximal elephant trunk technique with implantation of stent grafts to the ascending aorta. J Vasc Surg 2013;58:1700-4. https://doi.org/10.1016/j.jvs.2013.05.044