Endovascular redo aortic surgery

Jacob Budtz-Lilly, Kiattisak Hongku, Björn Sonesson, Nuno Dias, Tim Resch

Research output: Contribution to journalReview articlepeer-review

Abstract

Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger abdominal aortic aneurysm necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing. This can be achieved with Palmaz stents, endoanchors, and extension with fenestrated or branched endovascular repair. Thoracic aortic coverage may be required, and revascularization of the left subclavian artery should be considered. Technical issues such as these, as well as target vessel cannulation and accommodation of the new graft within the previous implanted graft, require experience and careful planning. Distal extension can likewise resolve a failing repair, and this may require the use of internal iliac artery embolization or iliac-branch devices. Redo aortic operations are technically demanding and are carried out with increased risks. Improving technology, such as fusion imaging, should mitigate some of this risk and are recommended.

Original languageEnglish
Pages (from-to)854-860
Number of pages7
JournalJournal of Cardiovascular Surgery
Volume58
Issue number6
DOIs
Publication statusPublished - 2017 Dec 1
Externally publishedYes

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Free keywords

  • Abdominal
  • Aorta
  • Aortic aneurysm
  • Endovascular procedures

Fingerprint

Dive into the research topics of 'Endovascular redo aortic surgery'. Together they form a unique fingerprint.

Cite this