MID-TERM ANCHORING ZONE–RELATED COMPLICATIONS AFTER THORACIC ENDOVASCULAR AORTIC REPAIR: A REPORT OF TWO CASES
11. international conferance on medical and health sciences, Madrid, İspanya, 23 - 31 Mayıs 2026, ss.34-40, (Tam Metin Bildiri)
- Yayın Türü: Bildiri / Tam Metin Bildiri
- Basıldığı Şehir: Madrid
- Basıldığı Ülke: İspanya
- Sayfa Sayıları: ss.34-40
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Recep Tayyip Erdoğan Üniversitesi Adresli: Evet
Özet
Objective Thoracic endovascular aortic repair (TEVAR) is a widely accepted minimally invasive treatment for thoracic aortic pathologies. Anchoring zone–related complications, however, may arise beyond the early postoperative period. This study presents two cases of rare mid-term anchoring zone complications occurring at approximately six months after TEVAR, highlighting the importance of routine imaging surveillance. Material and Methods Two patients who developed anchoring zone–related complications during mid-term follow-up after TEVAR were retrospectively evaluated. Clinical presentation, computed tomographic angiography (CTA) findings, and treatment strategies were analyzed. Results In the first case, a patient with non-A non-B aortic dissection previously treated with thoracic debranching and Zone 0 TEVAR was found to have a proximal anchoring zone pseudoaneurysm on routine six-month CTA. Open surgical repair with ascending aorta and total arch replacement was performed uneventfully. In the second case, a patient who underwent TEVAR for type III aortic dissection with intentional left subclavian artery coverage presented with acute dyspnea at six months. CTA revealed a large intrathoracic hematoma with active bleeding proximal to the left subclavian artery. A hybrid approach combining thoracic debranching and proximal Zone 0 TEVAR extension was successfully performed. Conclusion Mid-term anchoring zone complications after TEVAR, though rare, can be life-threatening. Clinical presentations range from asymptomatic pseudoaneurysm to acute intrathoracic hemorrhage. Symptom based follow-up alone is insufficient; routine CTA — particularly at six months — is essential for early detection. Management should be individualized through collaboration between cardiovascular surgeons and interventional radiologists. Keywords: TEVAR, anchoring zone, pseudoaneurysm, intrathoracic bleeding, thoracic aortic dissection, endovascular repair, mid-term complications