Chimney and periscope grafts to facilitate endovascular treatment of aortic transection in a patient with aberrant right subclavian artery.

Felice Pecoraro, Frank J. Veith, Mario Lachat, Sandra Vicente, Michael Glenck, Dieter Mayer

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: To report the use of parallel grafts to extend the proximal landing zone for stentgraftrepair of aortic transection involving an aberrant right subclavian artery (ARSA).Case Report: A 28-year-old patient was referred for treatment of traumatic aortic transectionwith contained rupture at the level of an ARSA. Immediate thoracic endovascular aorticrepair (TEVAR) was planned because of hemodynamic instability. To achieve rapid sealingand maintain perfusion to both subclavian arteries, a chimney stent to the left subclavianartery (LSA) and a periscope stent-graft to the ARSA were deployed successfully. Aftersurgical repair of all fractures, the patient was discharged 1 month after the initial injury ingood condition. Imaging follow-up at 10 months showed a stable repair, patent parallelgrafts, and no complications.Conclusion: TEVAR with chimney and periscope grafts proved to be a safe and quicktreatment for a patient requiring ARSA repair in acute aortic transection. This techniquemaintained blood flow to the ARSA and LSA in a totally endovascular approach, whichcould be very valuable in transection cases where bypass surgery to supra-aortic branchesis compromised or deemed challenging due to thoracic wall and/or neck trauma. Parallelgrafting can be a valuable tool to address any acute aortic pathology as it can be performedwith off-the-shelf devices.
Original languageEnglish
Pages (from-to)123-126
Number of pages4
JournalJournal of Endovascular Therapy
Volume21
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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