Intraoperative cone beam computed tomography-guided endovascular recanalization of an interrupted aorta

Philip L. Auyang; Ponraj Chinnadurai; Thomas MacGillivray; Alan B. Lumsden; John P. Breinholt; C. Huie Lin

doi:10.1016/j.jvs.2017.11.072

Intraoperative cone beam computed tomography-guided endovascular recanalization of an interrupted aorta

Philip L. Auyang, Ponraj Chinnadurai, Thomas MacGillivray, Alan B. Lumsden, John P. Breinholt, C. Huie Lin

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

A 42-year-old man sustained a stroke secondary to malignant hypertension and was found to have complete aortic interruption. We report a case of real-time image-guided endovascular repair to highlight the value of preprocedural planning and intraprocedural cone beam computed tomography. Two-dimensional fluoroscopy enhanced with three-dimensional landmarks from cone beam computed tomography was used to direct a Nykanen radiofrequency wire (Baylis Medical, Montreal, Quebec, Canada) through the interruption, avoiding critical adjacent structures. A covered Cheatham-Platinum stent (NuMED, Inc, Hopkinton, NY) was deployed successfully, recanalizing the thoracic aorta. The pressure gradient normalized, and the patient was discharged on postoperative day 1. At 10-month follow-up, the patient was on an antihypertensive regimen of two minimum-dose drugs.

Original language	English (US)
Pages (from-to)	1292-1296
Number of pages	5
Journal	Journal of Vascular Surgery
Volume	67
Issue number	4
DOIs	https://doi.org/10.1016/j.jvs.2017.11.072
State	Published - Apr 2018

Keywords

Adult
Anatomic Landmarks
Aorta, Thoracic/abnormalities
Aortography/methods
Computed Tomography Angiography
Cone-Beam Computed Tomography
Endovascular Procedures/instrumentation
Humans
Male
Predictive Value of Tests
Radiography, Interventional/methods
Stents
Treatment Outcome
Vascular Malformations/diagnostic imaging

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Surgery

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10.1016/j.jvs.2017.11.072

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title = "Intraoperative cone beam computed tomography-guided endovascular recanalization of an interrupted aorta",

abstract = "A 42-year-old man sustained a stroke secondary to malignant hypertension and was found to have complete aortic interruption. We report a case of real-time image-guided endovascular repair to highlight the value of preprocedural planning and intraprocedural cone beam computed tomography. Two-dimensional fluoroscopy enhanced with three-dimensional landmarks from cone beam computed tomography was used to direct a Nykanen radiofrequency wire (Baylis Medical, Montreal, Quebec, Canada) through the interruption, avoiding critical adjacent structures. A covered Cheatham-Platinum stent (NuMED, Inc, Hopkinton, NY) was deployed successfully, recanalizing the thoracic aorta. The pressure gradient normalized, and the patient was discharged on postoperative day 1. At 10-month follow-up, the patient was on an antihypertensive regimen of two minimum-dose drugs.",

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author = "Auyang, {Philip L.} and Ponraj Chinnadurai and Thomas MacGillivray and Lumsden, {Alan B.} and Breinholt, {John P.} and Lin, {C. Huie}",

year = "2018",

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doi = "10.1016/j.jvs.2017.11.072",

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AU - Auyang, Philip L.

AU - Chinnadurai, Ponraj

AU - MacGillivray, Thomas

AU - Lumsden, Alan B.

AU - Breinholt, John P.

AU - Lin, C. Huie

PY - 2018/4

Y1 - 2018/4

N2 - A 42-year-old man sustained a stroke secondary to malignant hypertension and was found to have complete aortic interruption. We report a case of real-time image-guided endovascular repair to highlight the value of preprocedural planning and intraprocedural cone beam computed tomography. Two-dimensional fluoroscopy enhanced with three-dimensional landmarks from cone beam computed tomography was used to direct a Nykanen radiofrequency wire (Baylis Medical, Montreal, Quebec, Canada) through the interruption, avoiding critical adjacent structures. A covered Cheatham-Platinum stent (NuMED, Inc, Hopkinton, NY) was deployed successfully, recanalizing the thoracic aorta. The pressure gradient normalized, and the patient was discharged on postoperative day 1. At 10-month follow-up, the patient was on an antihypertensive regimen of two minimum-dose drugs.

AB - A 42-year-old man sustained a stroke secondary to malignant hypertension and was found to have complete aortic interruption. We report a case of real-time image-guided endovascular repair to highlight the value of preprocedural planning and intraprocedural cone beam computed tomography. Two-dimensional fluoroscopy enhanced with three-dimensional landmarks from cone beam computed tomography was used to direct a Nykanen radiofrequency wire (Baylis Medical, Montreal, Quebec, Canada) through the interruption, avoiding critical adjacent structures. A covered Cheatham-Platinum stent (NuMED, Inc, Hopkinton, NY) was deployed successfully, recanalizing the thoracic aorta. The pressure gradient normalized, and the patient was discharged on postoperative day 1. At 10-month follow-up, the patient was on an antihypertensive regimen of two minimum-dose drugs.

KW - Adult

KW - Anatomic Landmarks

KW - Aorta, Thoracic/abnormalities

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KW - Endovascular Procedures/instrumentation

KW - Humans

KW - Male

KW - Predictive Value of Tests

KW - Radiography, Interventional/methods

KW - Stents

KW - Treatment Outcome

KW - Vascular Malformations/diagnostic imaging

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Intraoperative cone beam computed tomography-guided endovascular recanalization of an interrupted aorta

Abstract

Keywords

ASJC Scopus subject areas

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