Çağlar ÖZMEN, Arzu SHAHVERENOVA, Mustafa DEMİRTAŞ

Torakoabdominal Anevrizmanın Cardiatis Çok Katmanlı Akış Modülatörü ile Tedavisi

Torakoabdominal aort anevrizmalarının perkütan tedavisi son yıllarda giderek daha fazla kullanılmaktadır. Anevrizma tehdidi için Cardiatis çok katmanlı akış modülatör stentleri son yıllarda gittikçe artan sıklıkta kullanılmaktadır. Cardiatis çok katmanlı akış modülatörü ile tedavi edilen torakoabdominal aort anevrizmalı olgumuzu sunuyoruz. 78 yaşında bayan hasta karın ağrısı şikayeti ile hastaneye başvurdu. Bilgisayarlı tomografide maksimum 50 mm çapında abdominal aort anevrizması gösterdi. Hasta cerrahiyi reddetti, bu yüzden hastayı Cardiatis ile tedavi etmeye karar verdik. Anjiyografide, 16x40, 16x80 ve 16x80 mm'lik üç Cardiatis çok katmanlı stent arka arkaya distal torasik aorttan 1 cm'lik bir over-lap olacak şekilde implante edildi. Kontrol anjiyografisinde stentin iyi bir pozisyonu olduğu ve anevrizmal segmentin tamamen kapatıldığı görüldü. BT taraması, 6 ay ve 24 ay takip sürecinden sonra anevrizmanın gerilediğini gösterdi. Cardiatisin karmaşık anevrizmalar için kullanımı, etkinlikleri ve güvenlikleri tam olarak aydınlatılmadığı sürece tartışma konusu olmaya devam edecektir. Sonuç olarak, hastamızın başarılı ve hayat kurtarıcı tedavisine rağmen, karmaşık anevrizmalar için akış yönelimli stent kullanımı sadece tedavi alternatifi olmayan karmaşık anatomili vakalarla sınırlandırılmalıdır.

Anahtar Kelimeler:

Cardiatis çok katmanlı akış modülatörü, Endovasküler Tedavi, Karmaşık Anevrizmalar

Treatment of a Thoracoabdominal Aneurysm With the Cardiatis Multilayer Flow Modulator

Percutaneous treatment of thoracoabdominal aortic aneurysms have been increasingly used recent years. The Cardiatis multilayer flow modulator stents have been used for aneurysms threatment. We report our case and the results of the 2 years follow-up with thoracoabdominal aortic aneurysms treated with the Cardiatis multilayer flow modulator. A 78-year-old female patient was admitted to the hospital with abdominal pain. A computed tomography scan showed an aneurysm of the abdominal aorta with a maximal diameter of 50 mm. The patient refused open surgery, so we decided to treat the patient with a flow-diverting stent. In an angiography, 16x40, 16x80 and 16x80 mm three Cardiatis multilayer stent were successively implanted with an overlap of 1 cm from the distal thoracic aorta. A control angiography showed a good position of the stent and completely close the aneurysmal segment. A CT scan showed regression of the aneurysm with developing partial thrombus after the 6 month and 24 month follow-up process. The use of CMFM for complex aneurysms will remain a matter of debate as long as their efficacy and safety have not been completely elucidated. In conclusion, despite the successful and life-saving treatment of our patient, the use of flow-diverting stents for complex aneurysms should be limited only to those compassionate-use cases without treatment alternatives.

Keywords:

Cardiatis multilayer flow modulator, Complex aneurysms, Endovascular theraphy,

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