Emergency Retrograde Left Common Carotid Artery Stenting after Thoracic Endovascular Aortic Repair with Regional Cerebral Oxygen Saturation Monitoring: Report of Two Cases
نویسندگان
چکیده
Objective: Two cases in which emergency retrograde stenting were performed for occlusion of the left common carotid artery orifice that occurred during thoracic endovascular aortic repair are reported. Case Presentations: In males in their 70s with thoracic aortic aneurysm, oxygen saturation dropped in the left cerebrum immediately after deployment of the thoracic aortic stent graft under general anesthesia. The stent graft obstructed the orifice of the left common carotid artery, and recanalization was achieved by direct puncture of the cervical left common carotid artery and placing a balloon expandable stent at the orifice of the left common carotid artery. No postprocedural neurologic deficits were observed. Conclusion: Retrograde stenting of the orifice of the left common carotid artery is effective for thoracic aortic stent graft migration, and regional cerebral oxygen saturation is an important index. The cases are worth reporting as neurointerventionist may also be required to perform the procedure, which is usually performed by vascular surgeons.
منابع مشابه
Usage of external shunt in hybrid approach for aortic arch aneurysm to restore cerebral oxygenation.
A hybrid approach, combining open and endovascular procedures, may be a less invasive substitute to correct aortic arch pathologies in high-risk patients. We describe an 82-year-old male patient with an atherosclerotic aortic arch aneurysm, which was treated with proximal transposition of all arch branches and endovascular aortic arch repair. During the left common carotid artery reconstruction...
متن کاملCerebral regional oxygenation during aortic coarctation repair in pediatric population.
OBJECTIVE During repair of aortic coarctation, clamping of the transverse aortic arch proximal to the left common carotid artery occludes blood flow to the left carotid and vertebral arteries. The objective of the present study is to determine whether blood flow through the right carotid and vertebral arteries provides adequate cerebral blood flow during aortic cross-clamping, as assessed by ne...
متن کاملHybrid Technique to Correct Cerebral Malperfusion Following Repair of a Type A Aortic Dissection
A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation (rSO2) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right r...
متن کاملCarotid angioplasty and stenting in a patient with high grade stenosis of Internal Carotid Artery associated with both vertebral arteries and contralateral carotid occlusion
Severe internal carotid artery (ICA) stenosis is a common cause of cerebrovascular accident (CVA) in middle-aged patients. Contralateral carotid occlusion (CCO) in patients with severe ICA stenosis is associated with high risk of CVA. Carotid endarterectomy (CEA) is associated with more complications in patients with CCO than those without CCO. In this study, we present the case of a 61-year-ol...
متن کاملChallenges of “Reverse” Aortic Arch Debranching for Repair of the Ascending Aorta by Thoracic Endovascular Aortic Repair
INTRODUCTION Ascending aortic pathology presents a unique challenge for treatment by thoracic endovascular aortic repair (TEVAR), because of lack of adequate endograft landing zones. This report describes a unique "reverse" extra-anatomical aortic arch debranching procedure performed to enable TEVAR of the ascending aorta. REPORT A 71-year-old male presented with a large ascending aortic pseu...
متن کامل