Progress of the treatment for extended aortic aneurysms; is the frozen elephant trunk technique the next standard in the treatment of complex aortic disease including the arch?

Karck, Matthias; Kamiya, Hiroyuki
June 2008
European Journal of Cardio-Thoracic Surgery;Jun2008, Vol. 33 Issue 6, p1007
Academic Journal
Summary: Patients with extensive aortic aneurysms involving the ascending aorta, aortic arch, and the descending aorta are still considered to be a challenge for many cardiovascular surgeons. The introduction of the elephant trunk technique by Borst et al. in 1983 has greatly facilitated surgery on this kind of pathology and this technique has been recognized as a standard modality for treatment of extended aortic aneurysms. As a next step, the frozen elephant trunk technique has been introduced in some institutes in the late 1990s. With this technique, surgery is performed through a median sternotomy, and an endovascular stent-graft is placed into the descending aorta in an antegrade fashion through the opened aortic arch. Then the ascending aorta and the aortic arch are replaced conventionally. The frozen elephant trunk technique enables one-stage repair of extended aortic aneurysms in a certain patient cohort with similar operative mortality as with the conventional elephant trunk technique, in which a second-stage operation is a prerequisite. Although the surgical strategy should be adjusted specifically to each patient''s individual pathology, the frozen elephant trunk technique may become the next standard treatment for extended aortic aneurysm instead of its conventional variant.


Related Articles

  • Endovascular surgery for failed open aortic aneurysm repair von Segesser, Ludwig K.; Marty, Bettina; Tozzi, Piergiorgio; Huber, Christoph; Bruschweiler, Ivan; Gallino, Augusto; Hayoz, Daniel; Ruchat, Patrick // European Journal of Cardio-Thoracic Surgery;Sep2004, Vol. 26 Issue 3, p614 

    Objective: Determine the usefulness of endovascular surgery for repair of aortic lesions late after open surgical repair. Patients and methods: A retrospective analysis of our databank (Patient Analysis and Tracking System, Dendrite, UK) for 2000–2002 showed 286 descending thoracic and/or...

  • Endovascular Therapy for Recurrent Type III Endoleak. Schuurman, Jaap-Peter; Fioole, Bram; van den Heuvel, Daniel A. F.; de Vries, Jean Paul P. M. // Vascular & Endovascular Surgery;Feb2010, Vol. 44 Issue 2, p123 

    We report a case in which an aortouniiliac revision for a type IIIb endoleak of a primarily implanted AneuRx bifurcation endograft for infrarenal aortic aneurysm repair caused a renewed type IIIa endoleak 2 months after revision. The type IIIa endoleak was successfully repaired with a bridging...

  • Clinical outcome and technical considerations of late removal of abdominal aortic endografts: 8-year single-center experience. De Vries, Jean-Paul P. M.; Van Herwaarden, Joost A.; Overtoom, Tim Th.; Vos, Jan Albert; Moll, Frans L.; Van de Pavoordt, Eric D. W. M. // Vascular;May/Jun2005, Vol. 13 Issue 3, p135 

    During an 8-year period, 355 patients underwent endovascular repair of mainly true (97%) infrarenal aneurysms. After a mean follow-up of 48 months, 11 (3.1%) patients required conversion to open repair and 10 were eligible for open surgical intervention. Via a midline incision, explantation of...

  • Contemporary management of the infra-renal abdominal aortic aneurysm. Wilson, W. R. W.; Choke, E. C.; Dawson, J.; Loftus, I. M.; Thompson, M. M. // Surgeon (Edinburgh University Press);Dec2006, Vol. 4 Issue 6, p363 

    Abdominal aortic aneurysms (AAAs) principally affect men over 60 years of age. Aneurysms are usually asymptomatic and detected coincidentally or following the onset of symptoms. Elective repair of an AAA is considered when the diameter reaches 5.5cm or annual expansion exceeds 1cm. Rupture...

  • Primary aorto-enteric fistula: A rare complication of abdominal aortic aneurysm. Thomson, V. S.; Gopinath, K. G.; Joseph, E.; Joseph, G. // Journal of Postgraduate Medicine;Oct2009, Vol. 55 Issue 4, p267 

    A 70-year-old lady presented with recurrent gastrointestinal bleeding and septicemia caused by multiple enteric pathogens. She was diagnosed to have primary aorto-enteric fistula (PAEF) complicating abdominal aortic aneurysm. Endovascular aneurysm repair was carried out that arrested...

  • Evaluation of the effect of endovascular options on infrarenal abdominal aortic aneurysm repair. Sandridge, Layne C.; Baglioni Jr., A. J.; Kongable, Gail L.; Harthun, Nancy L.; Baglioni, A J Jr // American Surgeon;Aug2006, Vol. 72 Issue 8, p700 

    Endovascular devices designed to exclude flow to infrarenal abdominal aortic aneurysms (AAA) were approved by the Food and Drug Administration in the United States in 1999. This action allowed widespread use of this technology for AAA exclusion. The purpose of this report is to examine trends...

  • Endoleak detection and classification after endovascular treatment of abdominal aortic aneurysm: value of CEUS over CTA. Carrafiello, Gianpaolo; Recaldini, Chiara; Laganà, Domenico; Piffaretti, Gabriele; Fugazzola, Carlo; Laganà, Domenico // Abdominal Imaging;May/Jun2008, Vol. 33 Issue 3, p357 

    This paper focuses on the diagnostic value of CEUS in the detection and characterization of endoleaks in comparison with other imaging modalities, primary CDUS and CTA in the follow-up of endovascular abdominal aortic aneurysm repair. CEUS is an interesting alternative technique because of its...

  • Secondary surgical interventions after endovascular stent-grafting of the thoracic aorta Grabenwoger, Martin; Fleck, Tatjana; Ehrlich, Marek; Czerny, Martin; Hutschala, Doris; Schoder, Maria; Lammer, Johannes; Wolner, Ernst // European Journal of Cardio-Thoracic Surgery;Sep2004, Vol. 26 Issue 3, p608 

    Objective: The objective of the study was to evaluate mid-term durability and need for reinterventions after endovascular stent-grafting (ESG) in descending aortic aneurysms and dissections. Patients and Methods: Between November 1996 and February 2003 a total of 80 patients underwent ESG for...

  • Risk factors in abdominal aortic aneurysm and in Polish population aortoiliac occlusive disease and differences between them. Mikołajczyk-Stecyna, Joanna; Korcz, Aleksandra; Gabriel, Marcin; Pawlaczyk, Katarzyna; Oszkinis, Grzegorz; Słomski, Ryszard // Scientific Reports;12/20/2013, p1 

    Abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD) are multifactorial vascular disorders caused by complex genetic and environmental factors. The purpose of this study was to define risk factors of AAA and AIOD in the Polish population and indicate differences between diseases.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics