Treatment of aortic arch aneurysms with a modular transfemoral multibranched stent-graft: Initial experience

Cherrie Abraham, Christos Lioupis

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Objective: To present an initial experience with a new modular transfemoral multibranched stent-graft for treating aortic arch aneurysms. Methods: Six patients, considered high risk for open surgery, were treated with a custom-made branched stent-graft. Two patients had aortic arch aneurysms, three had descending thoracic aortic aneurysms involving the distal arch, and one had a saccular aneurysm of the arch adjacent to the origin of the innominate artery. All patients had undergone a staged left carotid subclavian bypass before the endovascular procedure. Each branched graft had a 12-mm side branch for the innominate artery and an 8-mm side branch for the left common carotid artery. The branches were extended into their respective target arteries with covered self-expanding stents. Results: Aneurysm exclusion without endoleak was successful in 5 of the 6 patients, and 11 of the 12 target vessels were successfully cannulated and preserved. Patient 1 developed a type I endoleak that was managed successfully with coiling and gluing of the aneurysm sac. Patients 2, 3, 5, and 6 had uneventful placement of the prostheses, with successful exclusion of the aneurysm sac. In patient 4, cannulation of the innominate branch was unsuccessful, and an extra-anatomic bypass was necessary to perfuse the right carotid and vertebral arteries. Conclusions: We have demonstrated the technical feasibility of a modular transfemoral branched stent-graft for treatment of aortic arch aneurysms. Our initial experience has shown that the method is relatively safe. Long-term follow-up is necessary to evaluate the efficacy and safety of this new device.

Original languageEnglish (US)
JournalJournal of Thoracic and Cardiovascular Surgery
Volume145
Issue number3 SUPPL.
DOIs
Publication statusPublished - Mar 2013
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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