J Korean Soc Vasc Surg.  2003 Nov;19(2):183-189.

Crawford Type III and IV Thoracoabdominal Aortic Aneurysm: 4 Cases Report

• Moon SM
• Son MS
• Lee KY
• Lee SM
• Koh SH
• Hong SW
• Yoon C
• Oh SM
• Park HC

Abstract

Thoracoabdominal aortic aneurysm is rare but potentially lethal, and its repair continues to present a surgical challenge because of obligate intraoperative visceral, renal, and spinal cord ischemia. In the past, the authors have experienced 4 cases of Crawford Type III and IV thoracoabdominal aortic aneurysm which were treated by a direct surgical approach. The diagnosis was made by CT scan, and aortogram. We repaired the thoracoabdominal aortic aneurysms with Knitted Dacron graft by a single inclusion button that encompasses the origins of the celiac, superior mesenteric, and right renal artery and left renal artery reconstruction with a separate side arm PTFE graft. the visceral ischemia time was less than 45 minutes in 3 operable cases and no paraplegia occurred after thoracoabdominal aortic reconstruction. two cases of Type IV thoracoabdominal aortic aneurysm with emergent presentation were fatal but elective surgical repairs of Type III and IV thoracoabdominal aortic aneurysm were survived. Appropriate patient selection and prevention of visceral or spinal cord ischemia may be helpful in the repair of Type III and IV thoracoabdominal aortic aneurysm.

Keyword

Aorta; Aneurysm

MeSH Terms

Aneurysm
Aorta
Aortic Aneurysm, Thoracic*
Arm
Diagnosis
Ischemia
Paraplegia
Patient Selection
Polyethylene Terephthalates
Polytetrafluoroethylene
Renal Artery
Spinal Cord Ischemia
Tomography, X-Ray Computed
Transplants
Polyethylene Terephthalates
Polytetrafluoroethylene