Abstract
We used a temporary AV shunt with a sieving device for perprocedural embolic protection in a thoracic endovascular aortic repair (TEVAR) for shaggy aorta. A 76-year-old man diagnosed as having an acute aortic dissection (DeBakey type IIIa) with intramural hematoma and severe atherosclerotic changes had been under a strict anti-hypertensive therapy. Two weeks after the onset, the diameter of dissecting aortic aneurysm increased to 58 mm. Considering the risk factors, such as past history of cerebral infarction, chronic obstructive lung disease, and renal dysfunction, TEVAR was performed 4 weeks after the onset. During the procedure, the side port of the 24-Fr introducer sheath was connected to a 12-Fr sheath inserted into the femoral vein. A filter with a pore size of 100 microns was placed between the sheaths, to filtrate the collected arterial blood. High amount of visible debris was caught by the filter. He had an uneventful postoperative course with no embolic events.
