ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Endovascular repair of type-V thoracoabdominal aortic aneurysms using parallel graft techniques
Murat Canyiğit 1, Emrah Uğuz2, Mete Hıdıroğlu2, Tülin Gümüş3, Muhammet Fethi Sağlam2, Hüseyin Çetin 1, Ali Çam 1, Erol Şener2
1Departments of Radiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
2Departments of Cardiovascular Surgery, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
3Departments of Anaesthesiology and Reanimation, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2016.12082
Background: This study aims to present mid-term outcomes of endovascular aortic repair of type-V thoracoabdominal aortic aneurysms using parallel grafts to maintain blood flow to renovisceral arteries.

Methods: Between March 2013 and March 2014, four consecutive patients (3 males, 1 female; mean age 66.8 years; range 63 to 73 years) with type-V thoracoabdominal aortic aneurysms underwent endovascular aortic repair with parallel grafts. Chimney and sandwich grafts were inserted from an axillobrachial access, while periscope grafts and aortic endografts were delivered via transfemoral access.

Results: The mean follow-up was 16.25 (range 9 to 22) months. All aortic stent-grafts and parallel grafts were implanted with 100% procedural success. The aortic aneurysms were excluded with thoracic endografts (n=11) and a bifurcated stent-graft. A total of 16 parallel grafts (8 sandwich grafts, 2 chimney grafts, and 6 periscope grafts) using 26 Viabahn®- coated stents were placed to maintain blood flow to eight renal and eight visceral arteries. Temporary worsening of kidney function was seen in a patient. During follow-up, three of the four patients were uneventful and a subdural hematoma developed in a patient in the first postoperative month. No postoperative mortality was seen in any patient. No aneurysmal growth was seen. All parallel grafts were patent. Minimal type-I and type-III endoleaks were observed in two patients with short-term follow-up.

Conclusion: The parallel graft technique to treat type-V thoracoabdominal aortic aneurysms is a feasible and less invasive alternative method with extremely low mortality rates.

Keywords : Chimney graft; coated stent; endovascular aortic repair; parallel graft; thoracoabdominal aortic aneurysm
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