Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-130
Contained Rupture of Thoracic Aneurysm Treated by TEVAR With Double-Chimney for Preserving Arch Branches
By Rohit Mody
Presenter
Rohit Mody
Authors
Rohit Mody1
Affiliation
Mody Harvard Cardiac Institute & Research Centre , India1,
View Study Report
TCTAP C-130
ENDOVASCULAR - Aorta Disease and Intervention
Contained Rupture of Thoracic Aneurysm Treated by TEVAR With Double-Chimney for Preserving Arch Branches
Rohit Mody1
Mody Harvard Cardiac Institute & Research Centre , India1,
Clinical Information
Patient initials or Identifier Number
82104
Relevant Clinical History and Physical Exam
Patient Details-
1. Patient was a 85 year old male 2. Patient was Hypertensive3. ECHO showed LV Dysfunction EF-20-25% 4. Hoarseness of voice 5. Patient was a known case of Dyslipidemia6. Patient was Malnourished7. CKD8. Patient had Moderate aortic Stenosis9. Suffering from breathlessness
1. Patient was a 85 year old male 2. Patient was Hypertensive3. ECHO showed LV Dysfunction EF-20-25% 4. Hoarseness of voice 5. Patient was a known case of Dyslipidemia6. Patient was Malnourished7. CKD8. Patient had Moderate aortic Stenosis9. Suffering from breathlessness
Relevant Test Results Prior to Catheterization
Patient was suffering from Hypertension, ECHO shows LV Dysfunction EF- 20-25%, diagnosed with CKD & Dyslipidemia
Relevant Catheterization Findings
Angiography reveals SVD LAD 85%. RCA & LCX normal This patient has got looks like thrombosed arch aneurysm at the posterior -inferior wall of the thoracic aorta at the Lt.Subclavian artery. Proximal thoracic aorta diameter measures34mm -35mm at the origin of Innominate artery. Aortogram shows aneurysmal Dilatation of Arch and Descending Thoracic aorta. Both the iliacs are aneurysmal and tortuous. Both common femoral arteries are adequate sized for procedure of Endovascular stent graft.
Interventional Management
Procedural Step
LM was hooked with EBU 3.5 6F and PCI to LAD was Done with 4x16mm DES, Femoral access done through atriotomy, Iliac straightened with stiff wire, Stent Graft Valiant Captiva 40x44mm Positioned across aneurysm from femoral arteriotomy also LSA and LCCA wired with stiff wires through brachial & carotid arteriotomy respectively Chimney stents placed across LSA with Lifestream stent 8x58mm & LCCA with Lifestream stent 8x26mm to Ascending Aorta and positioned proximal to the stent Graft. Good result was obtained with covered aneurysm and patent common carotid and left subclavian arteries.
Case Summary
To preserve covered critical branches during endografting, Chimney Technique for Endovascular Aneurysm Repair (ChEVAR) can be the savior. ChEVAR is a feasible treatment option for complex aortic repair involving one or more than one branch. ChEVAR technique provides two major advantages: off-the-shelf availability and lower resource-intensity. ChEVAR technique can give good bailout in emergency situation and can be done with no or minor complications.