Universität zu Köln

Bangard, Christopher, Franke, Mareike, Pfister, Roman, Deppe, Antje-Christin, Matoussevitch, Vladimir, Maintz, David and Chang, De-Hua (2014). Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts. Eur. Radiol., 24 (6). S. 1430 - 1435. NEW YORK: SPRINGER. ISSN 1432-1084

Full text not available from this repository.

Abstract

To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. aEuro cent Endoleaks after thoracic endovascular aortic repair are common in 15-30 %. aEuro cent Most endoleaks can be treated by endovascular means. aEuro cent Direct percutaneous endoleak repair is described as a bail-out option. aEuro cent Direct percutaneous aortic arch coil embolisation of type 1a endoleak is possible. aEuro cent Antibiotic prophylaxis should be administered case by case, considering individual risk factors.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bangard, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED Franke, Mareike UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Matoussevitch, Vladimir UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, De-Hua UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-437161
DOI:	10.1007/s00330-014-3143-8
Journal or Publication Title:	Eur. Radiol.
Volume:	24
Number:	6
Page Range:	S. 1430 - 1435
Date:	2014
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ENDOVASCULAR TREATMENT; THROMBIN INJECTION; ANEURYSM REPAIR Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43716