Aorta
TAA

Patient-tailored endovascular therapy of the thoracic aorta

This challenging case features a 65-year-old patient with multiple comorbidities, a 58 mm thoracic aneurysm, and a severely kinked, diseased aorta. 

Key questions include configuring the optimal proximal landing zone, navigating complex anatomy during endovascular repair, and reducing the risk of spinal cord ischemia.

Florian Elger
Florian Elger
University Medical Center Göttingen, Germany
Part I - Case presentation

Patient / Anatomy

  • A 65-year-old male patient.
  • Extensive coronary artery disease – PCI to RIM; chronic total occlusion of RCA.
  • Smoking history: 50 pack-years.
  • COPD.
  • Type 2 diabetes mellitus.
  • CKD II.
  • Severe depression.
  • Hyperlipidemia (HLP).
  • Progressive aneurysm, diameter 58 mm.
  • Kinked anatomy (proximal descending!).
  • Diseased aorta and Iliac arteries.
     
Endovascular therapy of the thoracic aorta: Kinked Anatomy (proximal descending!)
Endovascular therapy of the thoracic aorta: Progressive Aneurysm, Diameter 58mm

Distal Arch / Proximal descending

Endovascular therapy of the thoracic aorta: Distal Arch / Proximal Descending
Endovascular therapy of the thoracic aorta: Distal Arch / Proximal Descending

Length & extent 

Length & Extent
Endovascular therapy of the thoracic aorta: Length & Extent

Distal landing zone

Endovascular therapy of the thoracic aorta: Distal Landing zone

 

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Potential conflicts of interest / disclosures

Dr. Florian Elger: workshops and speaker for W.L. Gore, workshops and proctor for Terumo Aortic

Supported through an unrestricted educational grant from Gore