CT-fusion-guided thoracic endovascular aortic repair: Case report and literature review

Authors

  • Anton Khilchuk City Hospital no. 40, 9, ul. Borisova, Sestroretsk, St. Petersburg, 197706, Russian Federation ; St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
  • Artyom Payvin City Hospital no. 40, 9, ul. Borisova, Sestroretsk, St. Petersburg, 197706, Russian Federation
  • Sergey Scherbak St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
  • Valentin Guryev City Hospital no. 40, 9, ul. Borisova, Sestroretsk, St. Petersburg, 197706, Russian Federation
  • Evgeniy Karmazanashvili City Hospital no. 26, 2, ul. Kostyushko, St. Petersburg, 196247, Russian Federation
  • Dmitriy Lazakovich City Hospital no. 40, 9, ul. Borisova, Sestroretsk, St. Petersburg, 197706, Russian Federation

DOI:

https://doi.org/10.21638/spbu11.2021.305

Abstract

Interventional and hybrid methods of treatment, combining open surgical and endovascular repairs, are the most promising areas in the surgery of the thoracoabdominal aorta. Recent studies, however, have demonstrated that complex thoracic endovascular aneurysm repair (TEVAR) is one of the most high-dose endovascular interventions. In addition, TEVAR is associated with the use of a significant volume of contrast media (CM), which can lead to contrast-induced acute kidney injury (CI-AKI). The use of advanced imaging techniques and computed tomographic fusion (CT-fusion) in routine practice can potentially reduce operation duration, radiation exposure and CM volume usage. We analyzed the literature on CTfusion
in endovascular aortic repair and present a clinical case of a 50-year-old male with a history of concomitant blunt chest trauma. CT of the chest revealed an aneurysm of the arch and descending aorta after traumatic dissection of the aorta (IIIa DeBakey, type B Stanford), post-traumatic diaphragmatic hernia of the left dome of the diaphragm with stomach and intestinal loops prolapse. The patient underwent a staged hybrid intervention — subtotal aortic arch debranching followed by CT-fusion-guided semi-arch TEVAR. CT-fusion is a dynamically developing technology, may reduce the CM volume, the duration of the procedure and
radiation exposure and requires further research.

Keywords:

aorta, aorta, endovascular aortic repair, aortic aneurysm, computed tomography, CT‑fusion

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References


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Published

2021-09-30

How to Cite

Khilchuk, A., Payvin, A., Scherbak, S. ., Guryev , V. ., Karmazanashvili, E., & Lazakovich, D. (2021). CT-fusion-guided thoracic endovascular aortic repair: Case report and literature review. Vestnik of Saint Petersburg University. Medicine, 16(3), 180–189. https://doi.org/10.21638/spbu11.2021.305

Issue

Vol. 16 No. 3 (2021)

Section

Cardiology

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Articles of "Vestnik of Saint Petersburg University. Medicine" are open access distributed under the terms of the License Agreement with Saint Petersburg State University, which permits to the authors unrestricted distribution and self-archiving free of charge.

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