Endovascular Repair of Thoracoabdominal Aortic Aneurysms with Fenestrated-Branched Stent-Grafts

摘要

Candidates for endovascular thoracoabdominal aneurysm repair typically are considered to be high risk for open aneurysm repair due to their age, aneurysm morphology, or co-morbid conditions. Preoperative assessment typically includes a functional cardiac stress test followed by selective coronary angiography if necessary, transthoracic echocardi-ography, pulmonary function testing, routine blood work, and a physical examination. A clear understanding of the aortic, iliac, and femoral anatomy is critical to patient selection and device construction. High-resolution computerized tomography (CT) scans of the entire aorta are analyzed with multiplanar reconstructions and centerline of flow measurement techniques on a workstation (TeraRecon Inc., San Francisco, CA), using 3-dimensional (3D) image analysis techniques to assess the aortic morphology. Chronic aortic dissection and severe iliac disease are potential contraindications to a pure endovascular approach, and hybrid-type repairs are considered in these patients if they are not amenable to open surgical repair.