The overlapping effects of aortic occlusion, collateral blood flow, metabolism, oxygen supply and demand, surgical technique, and response to ischemia underlie the unpredictability of spinal cord ischemia and subsequent paralysis in the surgical treatment of thoracoabdominal aortic aneurysms (TAAAs). However,…
Aneurysms involving the thoracoabdominal aorta are uncommon, but they receive significant attention due to their complexity of repair and risk of end-organ impairment. Advances in preoperative planning, surgical technique, anesthesia, and postoperative management have led to improved outcomes, most notably…
Descending thoracic aortic aneurysms (TAAs) are categorized into three types. In type A the descending TAA starts at the level of the left subclavian artery and ends at the level of T6. Type B starts at T6 and ends at…
Endovascular aneurysm repair, which requires neither direct aortic exposure nor temporary interruption of aortic flow, is particularly appealing when treating thoracoabdominal aortic aneurysms (TAAAs). Yet more than a decade has passed since a multibranched stent graft was first used to…
Viabahn open revascularization technique (VORTEC) is a stent graft–based vascular connection technique that achieves 97% successful end-to-end sutureless anastomoses, which is useful especially when the traditional suture technique is cumbersome. Open graft repair of the aortic arch and thoracoabdominal aorta,…
It is not always feasible to obtain adequate sealing regions for endovascular grafts without compromising renal artery and visceral arterial blood flow when treating juxtarenal abdominal aortic aneurysms (AAAs) and thoracoabdominal aortic aneurysms (TAAAs). Similar anatomic constraints exist with respect…
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The first description of a remote placement of a stent graft was by Volodos in 1986, although it was undertaken in treating a stenosis and dissection. Because it was published in Russian, there was little notice in the English-speaking countries.…
Abdominal compartment syndrome (ACS) and intraabdominal hypertension (IAH) caused by elevated intraabdominal pressure (IAP) are commonly encountered in patients with ruptured abdominal aortic aneurysms (AAAs) and carry a high morbidity and mortality risk ( Table 1 ). However, IAH/ACS are…
Concomitant intraabdominal procedures with abdominal aortic aneurysm (AAA) repair are seldom necessary. The most life-threatening issue for the patient with concurrent nonvascular disease and an AAA is dealt with first, followed by the secondary procedure when it is medically safe.…