[Efficacy of endovascular repair in patients with abdominal aortic aneurysm complicating acute aortic syndrome].

OBJECTIVE: To evaluate the efficacy of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) on abdominal aortic aneurysm (AAA) patients complicating acute aortic syndrome (AAS).

METHODS: Data of 17 patients (16 men, mean age (65.2±6.9) years old) , who underwent simultaneous TEVAR and EVAR between September 2010 and June 2015 in Beijing Anzhen Hospital, were retrospectively reviewed.All patients were diagnosed with concomitant AAA and AAS by preoperative CTA.All abdominal aortic lesions were AAA and all thoracic aortic lesions were AAS.Under local anesthesia, simultaneous TEVAR and EVAR were performed and emergent simultaneous endovascular repair was performed in 2 patients.Follow up was made at 1 month, 3 months, 6 months, and yearly after the procedure.Procedure success rate, procedure related complications were evaluated.

RESULTS: Procedure was successful in all patients.The length of thoracic coverage was (21.0±4.6) cm.The operation time was 150(120, 170) min, and the hospitalization time was 7 (6, 12) d. After a mean of 27.0(5.5, 44.5) months follow up, there were no acute cardiopulmonary complications and contrast induced nephropathy.One patient developed spinal cord ischemia and resolved after treatment.One patient was died for aneurysm rupture at 6 months post operation.One patient developed type Ⅰb endoleak for expansion of right iliac artery at 9 months post operation and was successfully sealed by iliac stent-graft extension.

CONCLUSIONS: Combined TEVAR and EVAR can be performed successfully in patients with AAA complicating AAS.When anatomically feasible, simultaneous TEVAR and EVAR can be considered as a effective and safe therapy alternative to patients with multilevel aortic diseases.