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Aortic Conduit For TEVAR In
Descending Thoracic Aortic
Aneurysm Without Femoral Access
Apinan Uthaipaisanwong, M.D.
King Chulalongkorn Memorial Hospital
Bangkok, Thailand
Disclosure
Speaker name:
Apinan Uthaipaisanwong
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interest
71-year-old male presented with hemoptysis
Past History
• 10 years PTA
• Open infrarenal aortic aneurysm repair with tube graft
• 8 years PTA
• Total graft excision due to secondary aortoenteric fistula
• Aortic stump (below both renal arteries)
71-year-old
male
presented
with
hemoptysis
CTAmultiple
descending
thoracic aortic
aneurysms
Infrarenal Aortic Stump
What is the
plan?
What is the
plan?
Open Repair
What is the
plan?
Open Repair
TEVAR
Open Repair
Open Repair
Elderly patient
Open-chest
surgery
TEVAR is a standard
treatment
TEVAR
TEVAR
What is access site?
Adequate Landing
ZoneLess
Invasive
What is access site?
Rt
Subclavian
&
Common carotid
Artery
Lt Common
Carotid Artery Lt
Subclavian
Artery
What is access site?
Lt Subclavian
Artery
What is access site?
Lt Common
Carotid Artery
What is access site?
What is access site?
THE
Other
Access
Sites
Aortic Conduit
Aortic Conduit
Deployment
Deployment
Deployment
Postoperation
• Aortic conduit was removed with residual cuff 5 mm.
• Hemoptysis was resolved.
CTA follow up
Conclusion
• TEVAR after infrarenal aortic resection is a rare situation.
• Access sites such as common carotid a. and subclavian a. are not feasible due to technical difficulty.
• We propose aortic stump as an alternative route for access site.
Acknowledgement
•Assoc. Prof. Kritaya Kritayakirana M.D.
•Dr. Pawanrat Kranokpiraksa M.D.
•Dr.Nantiskarn Chanpen M.D.
•Dr.Nattawut Narueponjirakul M.D.
King Chulalongkorn Memorial Hospital
Bangkok, Thailand
Aortic Conduit For TEVAR In
Descending Thoracic Aortic
Aneurysm Without Femoral Access
Apinan Uthaipaisanwong, M.D.
King Chulalongkorn Memorial Hospital
Bangkok, Thailand
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