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J Thorac Cardiovasc Surg 2003;125:956-958
© 2003 The American Association for Thoracic Surgery

Brief Communications

Endovascular stent-graft repair for thoracoabdominal aneurysm after reconstruction of the superior mesenteric and celiac arteries

From the Second Department of Surgery, Kagoshima University Faculty of Medicine, Kagoshima, Japan.

Received for publication July 10, 2002. Accepted for publication Aug 20, 2002. Address for reprints: Yoshifumi Iguro, MD, The Second Department of Surgery, Kagoshima University, Faculty of Medicine, 8-350-1, Sakuragaoka Kagoshima City, Kagoshima Prefecture, 890-8520 Japan (E-mail: iguro@med6.kufm.kagoshimau.ac.jp).

The first 20% of the full text of this article appears below.

Thoracoabdominal aortic aneurysm (TAAA) is not considered on indication for endovascular stent-graft repair because of the need to revascularize the visceral vessels. This article details for the first time a case of TAAA repair in which an endovascular stent graft was placed after reconstruction of the visceral vessels.

Clinical summary

A 63-year-old woman was referred to our hospital for the treatment of a TAAA. The patient had tuberculosis and pleuritis at 16 and 21 years of age, respectively. Computed tomography and abdominal echocardiography revealed a porcelain descending aorta and a large saccular calcified aneurysm with mural thrombus in the thoracoabdominal aorta. The maximum aneurysmal diameter was 60 mm. Aortography showed a Crawford extent III TAAA involving the celiac artery and the superior mesenteric artery (SMA; Figure 1).

View larger version (96K): [in this window] [in a new window]   Fig. 1. Preoperative aortogram and computed tomogram. A, Preoperative aortogram showing a Crawford grade 3 saccular TAAA arising from the supraphrenic descending aorta and extending to the suprarenal aorta. The aneurysm involved the celiac artery and the SMA. B, Enhanced computed tomogram showing a large saccular calcified aneurysm, with mural thrombus in the thoracoabdominal aorta. The maximum aneurysmal diameter was 60 mm.

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