The risks of celiac artery coverage during endoluminal repair of thoracic and thoracoabdominal aortic aneurysms

Luis R. Leon, Joseph L Mills, William Jordan, Mark M. Morasch, Margaret Kovacs, Gary J. Becker, Bulent Arslan

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The risks of purposeful celiac artery coverage during endovascular thoracic aortic aneurysm repair (TEVAR) to obtain an adequate distal landing zone have received scant scientific attention. Patients undergoing TEVAR at 6 tertiary centers from January 2000 to June 2007 were identified (n = 434); cases requiring celiac artery exclusion (n = 19; 4.4% of the total) were analyzed. The mean follow-up was 8.7 months (range, 0.2-21.2). The mean patients' age was 73.6 years (range, 56-86); 57.9% were men. The mean aneurysm diameter was 6.7 cm (range, 5-8.6). In 2 patients, the celiac artery balloon occlusion test was performed prior to TEVAR. In both, intact collateral foregut circulation was seen. Both underwent TEVAR without celiac artery revascularization; 1 did well, whereas the other developed foregut ischemia. In 16 cases (84.2%), the celiac artery was not revascularized prior to TEVAR. In those patients, 19 complications were reported (3 deaths; 2 paraplegia). No similar events occurred in those who underwent celiac artery revascularization (n = 3). Celiac artery coverage during TEVAR is required in 4.4% of cases. TEVAR correlated with a nonnegligible number of major complications. Complications were more frequent and severe in patients who did not have celiac artery revascularization prior to TEVAR. Specific celiac artery coverage complications are rare and not readily predictable based on preprocedure arteriography.

Original languageEnglish (US)
Pages (from-to)51-60
Number of pages10
JournalVascular and Endovascular Surgery
Volume43
Issue number1
DOIs
StatePublished - Feb 2009

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Celiac Artery
Thoracic Aortic Aneurysm
Angioplasty
Balloon Occlusion
Collateral Circulation
Paraplegia
Aneurysm
Angiography
Ischemia

Keywords

  • Bowel ischemia
  • Paraplegia
  • TEVAR
  • Thoracoabdominal aortic aneurysm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

The risks of celiac artery coverage during endoluminal repair of thoracic and thoracoabdominal aortic aneurysms. / Leon, Luis R.; Mills, Joseph L; Jordan, William; Morasch, Mark M.; Kovacs, Margaret; Becker, Gary J.; Arslan, Bulent.

In: Vascular and Endovascular Surgery, Vol. 43, No. 1, 02.2009, p. 51-60.

Research output: Contribution to journalArticle

Leon, Luis R. ; Mills, Joseph L ; Jordan, William ; Morasch, Mark M. ; Kovacs, Margaret ; Becker, Gary J. ; Arslan, Bulent. / The risks of celiac artery coverage during endoluminal repair of thoracic and thoracoabdominal aortic aneurysms. In: Vascular and Endovascular Surgery. 2009 ; Vol. 43, No. 1. pp. 51-60.
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