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Successful endovascular repair of an aneurysm of the ductus diverticulum with a branched stent graft: Case report and review of literature  Naritatsu.

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Presentation on theme: "Successful endovascular repair of an aneurysm of the ductus diverticulum with a branched stent graft: Case report and review of literature  Naritatsu."— Presentation transcript:

1 Successful endovascular repair of an aneurysm of the ductus diverticulum with a branched stent graft: Case report and review of literature  Naritatsu Saito, MD, Takeshi Kimura, MD, Masanao Toma, MD, Masakazu Teragaki, MD, Hiroyoshi Minaminimura, MD, Toru Kita, MD, Kanji Inoue, MD  Journal of Vascular Surgery  Volume 40, Issue 6, Pages (December 2004) DOI: /j.jvs Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 a, Enhanced 2-dimensional computed tomography scan demonstrates 3 circles located in a hook shape beneath aortic arch (arrows), or the “triple star sign.” Maximum diameter of the aneurysm is 3.8 cm. Atherosclerotic changes in adjacent aorta were not found. Diameter of descending aorta is 2.6 cm. b, Three-dimensional reconstructions of computed tomography scan show the aneurysm projecting to the left pulmonary artery from the minor curvature of the aortic arch. Aneurysm had thrombus, and compressed the left pulmonary artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 Technique of single-branched stent-graft placement. Step 1, 22F introducer sheath is inserted in the descending thoracic aorta through the right femoral artery. Step 2, Folded stent graft is advanced to the descending thoracic aorta with a carrying wire. Step 3, 10F guiding catheter is inserted through the introducer sheath, along with the traction wire attached to the branched section. Free end of traction wire is inserted in the 10F guiding catheter and caught by the gooseneck wire. Step 4, Stent graft is unfolded and dilated with balloon inflation. Finally, carrying wire and traction wire are detached. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 A, Preprocedural angiogram shows the aneurysm. B, Folded stent graft is advanced. C, Aortic section of graft is dilated. D, Branched section of graft is dilated. E, No endoleak is seen on final angiogram. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

5 Fig 4 Two-dimensional (top) and 3-dimensional (bottom) computed tomography scans demonstrate complete exclusion of aneurysm. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

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