In situ bending of a thoracic stent-graft: a proposed novel technique to improve thoracic endograft seal.
OBJECTIVE
To demonstrate the feasibility of a novel technique that modifies the configuration of a thoracic stent-graft after deployment to comply with the arch curvature.


METHODS
The principle of a Bowden cable has been applied to direct a conventional thoracic stent-graft in situ after deployment. A suture placed at the proximal inner curve of a conventional thoracic stent-graft is fitted with a sliding, self-locking knot attached to a line that runs inside a catheter through the central rod of the stent-graft. Traction applied to this line directs the endograft post deployment, which allows for better apposition to the aortic wall. Shortening the inner curve makes the stent-graft bend. The extent of bending is fully controlled by the surgeon and held in place with the sliding knot. A release mechanism allows removal of all luminal components of the mechanism.


CONCLUSIONS
The described technique of directing a thoracic stent-graft in situ seems feasible and enables better apposition of the stent-graft in a glass model. It may improve the durability of thoracic stent-grafts in the aortic arch.
Kölbel
Tilo
T
Vascular Center Malmö-Lund, University Hospital MAS, Malmö, Sweden. tilo.kolbel@skane.se
Lee
Teng
T
Ivancev
Krassi
K
Resch
Timothy A
TA
Sonesson
Björn
B
Malina
Martin
M
D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D011474:Prosthesis Design; D015607:Stents; D013536:Suture Techniques