Extravascular endoconduit for compromised access route in patients with ruptured thoracic aortic aneurysm

Abstract

Some patients who undergo thoracic endovascular repair (TEVAR) for a thoracic aortic aneurysm have a compromised or unfavorable access route that requires additional intervention or another access route approach. We experienced a case involving an 80-year-old woman who developed a ruptured thoracic aortic aneurysm with an unfavorable access route characterized by a narrow external artery and severe atherosclerosis. She was severely frail due to a history of fractures and extensive intestinal resection for necrosis of the intestine. Although we planned to perform TEVAR following establishment of an internal endoconduit (IEC) of the common and external iliac arteries, the stent graft sheath did not pass IEC. We resolved the issue of the unfavorable access route with extravascular deployment of a stent graft following establishment of IEC (so-called extravascular endoconduit technique).

Keywords

• Compromised access route
• extravascular endoconduit
• thoracic endovascular repair