Elimination of late endoleak after endovascular repair of a dissecting thoracoabdominal aortic aneurysm

Shlomin V.V.¹, Korovin I.V.¹, Drozhzhin I.G.¹, Bondarenko P.B.¹, Puzdryak P.D.¹, Belousov E.Yu.², Kuzmin N.V.¹

1) Department of Vascular Surgery, Municipal Multimodality Hospital №2,
2) Saint Petersburg Research Institute of Emergency Medicine named after I.I. Dzhanelidze, Saint Petersburg, Russia

Described herein is a clinical case report regarding treatment of a 70-year-old male patient presenting with a late complication following endoprosthetic repair for a Stanford type B dissecting thoracic aortic aneurysm. The man was admitted to our hospital for persistent type IIb endoleak and an increased diameter of the aorta in its thoracic and thoracoabdominal portions. Two years previously, he had endured endoprosthetic repair of the thoracic aorta. The findings of computed tomography revealed negative dynamics manifesting as an increase in the diameter of the false channel of the arch and descending thoracic aorta with persistent type IIb endoleak. He was subjected to elimination of abdominal aortic dissection and type IIb endoleak with partial prosthetic repair of the descending thoracic portion of the aorta by means of prosthetic repair of the lower thoracic portion of the aorta between the stent graft and linear vascular Dacron prosthesis. The postoperative period was complicated by transient acute renal failure and paraparesis of the lower limbs. The patient was discharged on POD 14, with no endoleaks revealed on control computed tomography 3 months thereafter.

KEY WORDS: thoracoabdominal aneurysm, aortic dissection, thoracic endovascular aortic repair, endoleak, hybrid aortic surgery, open aortic surgery.

P. 180

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