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The management of aortic lesions involving the aortic arch in patients who cannot tolerate thoracotomy is a challenge. A 32-year-old woman who underwent a giant aneurysm at the proximal end of the descending aorta with significant vascular wall calcification. The patient underwent Castor single-branched stent-grafting in the brachiocephalic trunk combined with surgical supra-aortic debranching, which avoided surgical aortic arch replacement and stent fenestration.reopening. The patient was followed up for 9 months, and surgery-related complications were not observed. Hybrid arch repair with supra-aortic debranching and using Castor single-branched stent can be used to treat aortic lesions involving the aortic arch.
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http://dx.doi.org/10.1055/s-0042-1750427 | DOI Listing |
JACC Case Rep
August 2025
Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Texas, USA. Electronic address:
Bird-beak configuration after endovascular arch repair refers to a gap between the proximal stent and the lesser curvature of the aortic arch that can potentially lead to life-threatening complications through the formation of a 1A endoleak. This case describes a patient who developed a symptomatic type 1A endoleak due to bird-beaking, years after thoracic endovascular aneurysm repair and a complex supra-aortic debranching. The case was further complicated by a stenosis of the left common carotid artery diagnosed with duplex ultrasound and intraoperative transcranial Doppler exam.
View Article and Find Full Text PDFWe report our experience of six patients admitted to our hospital during January - July 2023 with complex aortic conditions treated with a two-stage hybrid procedure, consisting of surgical debranching - bypass grafting - of the supra-aortic branches off-pump and stent graft placement for Thoracic Endovascular Aortic Repair (TEVAR). Clinical features: The clinical cases we present highlight the use of TEVAR in both chronic (Type B aortic dissections, pseudoaneurysms, and penetrating aortic ulcers) and acute conditions (traumatic aortic transections and ruptured aortic aneurysms). TEVAR is a less invasive surgical approach for management of these critical patients, having as benefits: smaller incisions, avoiding operative risks associated with the classical procedure, shorter recovery time after the intervention and lower hospitalization costs.
View Article and Find Full Text PDFKyobu Geka
May 2025
Department of Cardiovascular Surgery, Ayase Heart Hospital, Tokyo, Japan.
Eight years previously, a 76-year-old man underwent an open surgical repair of an infectious abdominal aortic aneurysm through a median laparotomy. The abdominal aorta was resected, and blood flow to the lower extremities was reconstructed using an extra-anatomical bypass from the right axillary artery to the bilateral femoral arteries. A computed tomography (CT) scan revealed a distal aortic arch aneurysm just below the left subclavian artery, with a maximum diameter of 58 mm.
View Article and Find Full Text PDFJ Vasc Surg
June 2025
Vascular and Endovascular Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Objective: The aim of this study is to evaluate the safety, efficacy, and clinical outcomes of endovascular aortic arch repair using the Nexus and Nexus Duo endograft systems.
Methods: A multicenter, retrospective study with prospectively collected data was conducted as part of the Italian Nexus Aortic aRCH Endovascular Repair Registry (INARCHER) between 2019 and 2024. Nexus platforms include an off-the-shelf bimodular single branch endograft and a custom-made double-branch device.
J Cardiovasc Surg (Torino)
June 2025
Aortic Center, Marie Lannelongue Hospital, GHPSJ, Paris Saclay University, Le Plessis Robinson, France.
Complete thrombosis of the false lumen in chronic aortic dissection is essential to achieve positive aortic remodeling. However, persistent perfusion through aortic collaterals, dissected supra-aortic trunks (SAT), and renovisceral arteries often complicate this process. Our approach to treat chronic dissections integrates TEVAR and custom-made FBEVAR, often combined with supra-aortic trunk debranching or frozen elephant trunk (FET) procedures.
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