Endoluminal Repair of a Thoracic Arch Aneurysm Using a Scallop-Edged Stent-Graft

Abstract

Purpose:

To report a new technique of endoluminal thoracic aortic arch aneurysm repair using a scalloped stent-graft.

Case Report:

A 79-year-old man presented with a 7.5-cm thoracic aneurysm involving the inner curve of the aortic arch. Endoluminal repair was performed with a scalloped stent-graft that allowed perfusion of the brachiocephalic (innominate) artery. Preliminary extra-anatomical left common carotid and subclavian artery bypass grafting had been performed to allow coverage of the origins of these vessels.

Conclusions:

The use of fenestrated endoluminal grafts in the aortic arch can be achieved safely and may increase the treatment options for the high-risk patient.

Keywords

endovascular repair stent-graft thoracic aortic aneurysm aortic arch scalloped graft innominate artery

Get full access to this article

View all access options for this article.

References

LeMaire

Miller

Conklin

. Estimating group mortality and paraplegia rates after thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2003; 75: 508–513.

Cina

Lagana

Bruin

. Thoracoabdominal aortic aneurysm repair, a prospective cohort study of 121 cases. Ann Vasc Surg. 2002; 16: 631–638.

Kato

Shimono

Hirano

. Aortic arch aneurysms: Treatment with extraanatomical bypass and endovascular stent-grafting. Cardiovasc Intervent Radiol. 2002; 25: 419–422.

Criado

Clark

Barnatan

. Stent graft repair in the aortic arch and descending thoracic aorta: A 4-year experience. J Vasc Surg. 2002; 36: 1121–1128.

Görich

Asquan

Seifarth

. Initial experience with intentional stent-graft coverage of the subclavian artery during endovascular thoracic aortic repairs. J Endovasc Ther. 2002; 9(suppl II): II-39–II-43.

Criado

Barnatan

Rizk

. Technical strategies to expand stent-graft applicability in the aortic arch and proximal descending thoracic aorta. J Endovasc Ther. 2002; 9(suppl II): II-32–II-38.

Burks

Faries

Gravereaux

. Endovascular repair of thoracic aortic aneurysms: Stent-graft fixation across the aortic arch vessels. Ann Vasc Surg. 2002; 16: 24–28.

Kahn

Marin

Hollier

. Induction of ventricular fibrillation to facilitate endovascular stent graft repair of thoracic aortic aneurysms. Anesthesiology. 1998; 88: 534–536.

Thompson

Gaxotte

Rodriguez

. Endoluminal stent grafting of the thoracic aorta: Initial experience with the Gore Excluder. J Vasc Surg. 2002; 35: 1163–1170.

10.

Dorros

Cohn

. Adenosine-induced transient cardiac asystole enhances precise deployment of stent-grafts in the thoracic or abdominal aorta. J Endovasc Surg. 1996; 3: 270–272.