Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair

A 69-year-old man with chest pain was diagnosed with acute type B aortic dissection with the entry tear located at distal arch and a distal aortic arch aneurysm. Therefore, we performed debranching thoracic endovascular aortic repair 2 weeks after type B aortic dissection onset. First, the graft was...

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Main Authors: Satoshi Sakakibara, MD, Takashi Yamauchi, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468428724002910
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author Satoshi Sakakibara, MD
Takashi Yamauchi, MD, PhD
author_facet Satoshi Sakakibara, MD
Takashi Yamauchi, MD, PhD
author_sort Satoshi Sakakibara, MD
collection DOAJ
description A 69-year-old man with chest pain was diagnosed with acute type B aortic dissection with the entry tear located at distal arch and a distal aortic arch aneurysm. Therefore, we performed debranching thoracic endovascular aortic repair 2 weeks after type B aortic dissection onset. First, the graft was anastomosed to bilateral axillary arteries. After clamping the left common carotid artery (LCCA), the regional cerebral oxygen saturation decreased notably. Therefore, we used selective cerebral perfusion using a roller pump with a filter to prevent embolization, a 24F sheath inserted into the left common femoral artery (drainage cannula), and a balloon perfusion catheter inserted into the LCCA (arterial cannula). This technique improved the rSO2 and was continued during anastomosis of the graft to the LCCA. Thoracic endovascular aortic repair was performed after debranching from the right axillary artery to the LCCA and left axillary artery. The patient was discharged 7 days postoperatively without cerebral complications.
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spelling doaj-art-fbb5037e00b94e7fb7b43d81f5c23ef02025-08-20T03:06:00ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-04-0111210170710.1016/j.jvscit.2024.101707Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repairSatoshi Sakakibara, MD0Takashi Yamauchi, MD, PhD1Correspondence: Satoshi Sakakibara, MD, Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, Osaka 578-8588, Japan; Department of Cardiovascular Surgery, Higashiosaka City Medical Center, Higashiosaka, Osaka, JapanDepartment of Cardiovascular Surgery, Higashiosaka City Medical Center, Higashiosaka, Osaka, JapanA 69-year-old man with chest pain was diagnosed with acute type B aortic dissection with the entry tear located at distal arch and a distal aortic arch aneurysm. Therefore, we performed debranching thoracic endovascular aortic repair 2 weeks after type B aortic dissection onset. First, the graft was anastomosed to bilateral axillary arteries. After clamping the left common carotid artery (LCCA), the regional cerebral oxygen saturation decreased notably. Therefore, we used selective cerebral perfusion using a roller pump with a filter to prevent embolization, a 24F sheath inserted into the left common femoral artery (drainage cannula), and a balloon perfusion catheter inserted into the LCCA (arterial cannula). This technique improved the rSO2 and was continued during anastomosis of the graft to the LCCA. Thoracic endovascular aortic repair was performed after debranching from the right axillary artery to the LCCA and left axillary artery. The patient was discharged 7 days postoperatively without cerebral complications.http://www.sciencedirect.com/science/article/pii/S2468428724002910Selected cerebral perfusionTEVARINVOSrSO2
spellingShingle Satoshi Sakakibara, MD
Takashi Yamauchi, MD, PhD
Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
Journal of Vascular Surgery Cases and Innovative Techniques
Selected cerebral perfusion
TEVAR
INVOS
rSO2
title Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
title_full Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
title_fullStr Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
title_full_unstemmed Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
title_short Selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
title_sort selective cerebral perfusion for reduced cerebral blood flow during debranching thoracic endovascular aortic repair
topic Selected cerebral perfusion
TEVAR
INVOS
rSO2
url http://www.sciencedirect.com/science/article/pii/S2468428724002910
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