A visceral patch aneurysm is a significant complication after extensive thoracoabdominal aneurysm repair, and open procedures to correct these lesions are associated with a high perioperative mortality. We report the case of a 6-cm visceral patch aneurysm occurring in a patient with a completely replaced descending and abdominal aorta that was successfully corrected by staged debranching and endovascular repair with a dedicated thoracic endograft. Hybrid procedures are a successful option to treat complex repairs in the reoperative setting. They have the potential to lower perioperative risk and enhance patient care.
Dardik A. , Perler BA , Roseborough GS , Williams GMAneurysmal expansion of the visceral patch after thoracoabdominal aortic replacement: an argument for limiting patch size ? J Vasc Surg.2001;34: 405-409 ; discussion 410 .
2.
Tshomba Y. , Melissano G. , Civilini E. , Setacci F. , Chiesa R.Fate of the visceral aortic patch after thoracoabdominal aortic repair . Eur J Vasc Endovasc Surg.2005;29: 383-389 .
3.
Carrel TP , Signer C.Separate revascularization of the visceral arteries in thoracoabdominal aneurysm repair . Ann Thorac Surg.1999;68: 573-575 .
4.
Dias RR , Coselli JS , Stolf NA , Dias AR , Mady C. , Oliveira SAAneurysmal dilation of the reimplant segment of the visceral vessels after thoracoabdominal aneurysm correction . Arq Bras Cardiol. 2003;81: 273-278 .
5.
Lombardi JV , Carpenter JP , Pochettino A. , Sonnad SS , Bavaria JEThoracoabdominal aortic aneurysm repair after prior aortic surgery . J Vasc Surg.2003;38: 1185-1190 .
6.
Inoue K. , Iwase T. , Sato M. , et al. Transluminal endovascular branched graft placement for a pseudoaneurysm: reconstruction of the descending thoracic aorta including the celiac axis . J Thorac Cardiovasc Surg.1997;114: 859-861 .
7.
Black SA , Wolfe JH , Clark M. , Hamady M. , Cheshire NJ , Jenkins MPComplex thoracoabdominal aortic aneurysms: endovascular exclusion with visceral revascularization . J Vasc Surg.2006;43: 1081-1089 ; discussion 1089 .
8.
Flye MW , Choi ET , Sanchez LA , et al. Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm . J Vasc Surg.2004;39: 454-458 .
9.
Peterson BG , Pearce WH , Resnick SA , Eskandari MKStent-graft treatment of thoracoabdominal aortic aneurysms after complete visceral debranching . J Vasc Interv Radiol.2006;17: 1519-1525 .
10.
Zhou W. , Reardon ME , Peden EK , Lin PH , Bush RL , Lumsden ABEndovascular repair of a proximal aortic arch aneurysm: a novel approach of supra-aortic debranching with antegrade endograft deployment via an anterior thoracotomy approach . J Vasc Surg.2006;43: 1045-1048 .
11.
Lundbom J. , Hatlinghus S. , Aadahl P. , Myhre HOEndovascular treatment of vascular emergencies and complications following previous vascular surgery . Eur J Vasc Endovasc Surg.2000;19: 205-209 .
12.
Juvonen T. , Biancari F. , Ylonen K. , Perala J. , Rimpilainen J. , Lepojarvi M.Combined surgical and endovascular treatment of pseudoaneurysms of the visceral arteries and of the left iliac arteries after thoracoabdominal aortic surgery . Eur J Vasc Endovasc Surg.2001;22: 275-277 .
