PMC8181208_01
Three dimensional reconstruction of the thoraco-abdominal aorta showing the aneurysm and previous thoracic aortic repair locations. Red solid arrow denotes the distal extent of previous thoracic repair. Blue solid arrow denotes level of diaphragm.
gr1.jpg
PMC8181208_01_gr1.jpg
fig1
He had a residual chronic dissection of the entire native thoraco-abdominal aortic segment, which progressed in diameter from 38 mm to 45 mm over six months (Fig. 1).
Intra-operative image of the first stage repair showing an infrarenal aortobiliac graft with retrograde visceral bypasses.
gr2.jpg
PMC8181208_01_gr2.jpg
fig2
The main body of the graft was left long (Fig. 2) to accommodate the distal landing zone for a stent graft.
Three dimensional reconstruction showing infrarenal aortic repair with visceral debranching, and endovascular stenting across the thoraco-abdominal aorta. Yellow arrow: coeliac trunk bypass; red arrow: left renal artery bypass; green arrow: superior mesenteric artery bypass; blue arrow: right renal artery bypass.
gr3.jpg
PMC8181208_01_gr3.jpg
fig3
Follow up CT angiograms at five days (Fig. 3) and 11 months post-treatment showed exclusion of the aneurysm with unchanged size and a small type II endoleak originating from a posterior intercostal branch.