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Title: Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi

Abstract

BackgroundAortic thrombi in the ascending aorta or aortic arch are rare but are associated with a relevant risk of major stroke or distal embolization. Although stent grafting is commonly used as a treatment option in the descending aorta, only a few case reports discuss stenting of the aortic arch for the treatment of a thrombus. The use of bare metal stents in this setting has not yet been described.MethodsWe report two cases of ascending and aortic arch thrombus that were treated by covering the thrombus with an uncovered stent. Both procedures were performed under local anesthesia via a femoral approach. A femoral cutdown was used in one case, and a total percutaneous insertion was possible in the second case.ResultsBoth procedures were successfully performed without any periprocedural complications. Postoperative recovery was uneventful. In both cases, no late complications or recurrent embolization occurred at midterm follow-up, and control CT angiography at 1 respectively 10 months revealed no stent migration, freely perfused supra-aortic branches, and no thrombus recurrence.ConclusionTreating symptomatic thrombi in the ascending aorta or aortic arch with a bare metal stent is feasible. This technique could constitute a minimally invasive alternative to a surgical intervention or complex endovascular therapy with fenestrated ormore » branched stent grafts.« less

Authors:
; ;  [1]
  1. University Hospital RWTH Aachen, Department of Thoracic, Cardiac and Vascular Surgery (Germany)
Publication Date:
OSTI Identifier:
22121725
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 36; Journal Issue: 4; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANESTHESIA; AORTA; BIOMEDICAL RADIOGRAPHY; GRAFTS; HEALTH HAZARDS; METALS; SURGERY; THERAPY; THROMBOSIS

Citation Formats

Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de, Hoffman, Andras, Autschbach, Ruediger, and Damberg, Anneke L. M.,. Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi. United States: N. p., 2013. Web. doi:10.1007/S00270-013-0566-6.
Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de, Hoffman, Andras, Autschbach, Ruediger, & Damberg, Anneke L. M.,. Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi. United States. https://doi.org/10.1007/S00270-013-0566-6
Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de, Hoffman, Andras, Autschbach, Ruediger, and Damberg, Anneke L. M.,. 2013. "Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi". United States. https://doi.org/10.1007/S00270-013-0566-6.
@article{osti_22121725,
title = {Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi},
author = {Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de and Hoffman, Andras and Autschbach, Ruediger and Damberg, Anneke L. M.,},
abstractNote = {BackgroundAortic thrombi in the ascending aorta or aortic arch are rare but are associated with a relevant risk of major stroke or distal embolization. Although stent grafting is commonly used as a treatment option in the descending aorta, only a few case reports discuss stenting of the aortic arch for the treatment of a thrombus. The use of bare metal stents in this setting has not yet been described.MethodsWe report two cases of ascending and aortic arch thrombus that were treated by covering the thrombus with an uncovered stent. Both procedures were performed under local anesthesia via a femoral approach. A femoral cutdown was used in one case, and a total percutaneous insertion was possible in the second case.ResultsBoth procedures were successfully performed without any periprocedural complications. Postoperative recovery was uneventful. In both cases, no late complications or recurrent embolization occurred at midterm follow-up, and control CT angiography at 1 respectively 10 months revealed no stent migration, freely perfused supra-aortic branches, and no thrombus recurrence.ConclusionTreating symptomatic thrombi in the ascending aorta or aortic arch with a bare metal stent is feasible. This technique could constitute a minimally invasive alternative to a surgical intervention or complex endovascular therapy with fenestrated or branched stent grafts.},
doi = {10.1007/S00270-013-0566-6},
url = {https://www.osti.gov/biblio/22121725}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 4,
volume = 36,
place = {United States},
year = {Thu Aug 01 00:00:00 EDT 2013},
month = {Thu Aug 01 00:00:00 EDT 2013}
}