Frontiers in Surgery (Nov 2016)
Thoracic aorta aneurysm repair in a patient with a solitary kidney: Hybrid Surgery as a bailout procedure
Abstract
Thoracic endovascular aortic repair (TEVAR) is an emerging treatment option for thoracic aorta aneurysms (TAA). Endovascular access is a challenge. We present a novel TEVAR-technique in a patient with single kidney and a 6.4cm TAA. Attempting to place a sheath through iliac arteries was unsuccessful. The decision to proceed to hybrid-TEVAR was made. The protection of the solitary kidney was achieved through axillo-femoral bypass, followed by an end-to-side anastomosis between the aorta and a bifurcated graft. Through the graft, a stent was introduced in the thoracic aorta. With the use of contrast material, the right position of the graft was confirmed.
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