A double-barrel stent-graft for endovascular repair of the aortic arch.
OBJECTIVE
To extend the role of endovascular aneurysm repair in the presence of angulation and dilatation of the distal arch that compromise the proximal implantation site.


METHODS
A 70-year-old man with an asymptomatic 7-cm thoracic aortic aneurysm was treated with a TAG stent-graft. However, attempts to gain secure hemostatic implantation of the endograft resulted in inadvertent coverage of the subclavian and left carotid arteries. Flow to the left carotid artery was re-established by transcarotid insertion of a self-expanding covered stent alongside the primary stent-graft.


CONCLUSIONS
This technique may have a role as an intended part of endovascular repair when there is no suitable implantation site in the descending thoracic aorta.
Hiramoto
Jade S
JS
Division of Vascular Surgery, University of California San Francisco, California 94143-0222, USA. hiramotoj@surgery.ucsf.edu
Schneider
Darren B
DB
Reilly
Linda M
LM
Chuter
Timothy A M
TA
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D015607:Stents; D014057:Tomography, X-Ray Computed