Image in Cardiology
Aortic arch rescued through double-chimney technique
Tratamento endovascular de aneurisma do arco aórtico pela técnica de double-chimney
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Follow-up CTA at one month revealed no endoleak and patency of the innominate and LCCA stent grafts (B, C, D).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 62-year-old man with a history of hypertension, smoking, chronic obstructive pulmonary disease and coronary artery disease had a saccular aneurysm in the distal aortic arch (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A) involving the origin of the left subclavian artery (LSA), with a maximum diameter of 65 mm and a short proximal neck distancing 13 mm from the origin of the left common carotid artery (LCCA).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">He was considered at high surgical risk and was referred for thoracic endovascular aortic repair with simultaneous preservation of perfusion of the innominate artery and LCCA through double-chimney technique.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The procedure was performed under general anesthesia. A Gore<span class="elsevierStyleSup">®</span> TAG<span class="elsevierStyleSup">®</span> stent graft was first inserted through the right common femoral artery and deployed at the distal end of the aneurysm, and a second one was inserted into the ascending aorta distally overlapping with the first. Two Gore<span class="elsevierStyleSup">®</span> VIABAHN<span class="elsevierStyleSup">®</span> stent grafts were introduced through the right axillary artery and LCCA and deployed at the proximal edge of the proximal TAG stent graft. Post-procedure computed tomography angiography (CTA) revealed a type II endoleak from the LSA, but follow-up CTA at one month revealed no endoleak and patency of the stent grafts (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B, C and D).</p><p id="par0020" class="elsevierStylePara elsevierViewall">The double chimney is a recently introduced endovascular technique that provides an alternative to surgical treatment of aortic arch disease with preservation of the arch branches. There are a few case reports worldwide with acceptable short-term results, most associated with lower mortality and stroke rates compared to surgical or hybrid techniques. This case represents the first experience in Portugal with the double-chimney technique and long-term data are awaited.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-10-06" "fechaAceptado" => "2014-12-15" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1675 "Ancho" => 1486 "Tamanyo" => 277685 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pre-procedure computed tomography angiography (CTA) showing a large aneurysm in the distal aortic arch involving the origin of the left subclavian artery (A). Follow-up CTA at one month revealed no endoleak and patency of the innominate and LCCA stent grafts (B, C, D).</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003400000005/v1_201505200240/S087025511500102X/v1_201505200240/en/main.assets" "Apartado" => array:4 [ "identificador" => "357" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Imagens em cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003400000005/v1_201505200240/S087025511500102X/v1_201505200240/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511500102X?idApp=UINPBA00004E" ]
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| 2021 Novembro | 43 | 29 | 72 |
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| 2021 Setembro | 25 | 28 | 53 |
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| 2017 Fevereiro | 34 | 15 | 49 |
| 2017 Janeiro | 28 | 4 | 32 |
| 2016 Dezembro | 23 | 7 | 30 |
| 2016 Novembro | 20 | 7 | 27 |
| 2016 Outubro | 19 | 3 | 22 |
| 2016 Setembro | 10 | 7 | 17 |
| 2016 Agosto | 13 | 3 | 16 |
| 2016 Julho | 8 | 4 | 12 |
| 2016 Junho | 1 | 6 | 7 |
| 2016 Maio | 10 | 0 | 10 |
| 2016 Abril | 8 | 4 | 12 |
| 2016 Maro | 27 | 13 | 40 |
| 2016 Fevereiro | 49 | 12 | 61 |
| 2016 Janeiro | 27 | 3 | 30 |
| 2015 Dezembro | 30 | 14 | 44 |
| 2015 Novembro | 27 | 8 | 35 |
| 2015 Outubro | 31 | 16 | 47 |
| 2015 Setembro | 25 | 12 | 37 |
| 2015 Agosto | 37 | 13 | 50 |
| 2015 Julho | 56 | 26 | 82 |
| 2015 Junho | 68 | 24 | 92 |
| 2015 Maio | 92 | 54 | 146 |
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