title: Use of the right brachio-femoral wire approach to manage a thoracic aortic aneurysm in an extremely angulated and tortuous aorta with an endoluminal stent graft.
abstract: The presence of a tortuous, elongated thoracic aorta and an angulated arch poses a technical challenge for the delivery of an endoluminal graft to the target site to exclude management of a thoracic aortic aneurysm. Despite the availability of a flexible delivery sheath system, adjunct techniques are necessary to deal with extremely tortuous thoracic aortas. The use of a brachio-femoral wire with tension applied at both ends is a useful technique to deliver an endoluminal graft in an angulated thoracic arch. We describe the use of a right brachio-femoral wire approach to treat a thoracic aortic aneurysm in a 75-year-old man with an elongated, tortuous and angulated arch aorta.
authors.affiliation: Division of Cardiac Surgery, North Western Memorial Hospital, 201 East Huron Street, Galter 11-140, Chicago, IL 60611, USA. jkpodonu@yahoo.com
authors.forename: Jacques
authors.initials: J
authors.lastname: Kpodonu
authors.forename: Julio A
authors.initials: JA
authors.lastname: Rodriguez-Lopez
authors.forename: Venkatesh G
authors.initials: VG
authors.lastname: Ramaiah
authors.forename: Edward B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D001916:Brachial Artery / Q000000981:diagnostic imaging; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome