title: In situ bending of a thoracic stent-graft: a proposed novel technique to improve thoracic endograft seal.
abstract: 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.
authors.affiliation: Vascular Center Malmö-Lund, University Hospital MAS, Malmö, Sweden. tilo.kolbel@skane.se
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
authors.forename: Teng
authors.initials: T
authors.lastname: Lee
authors.forename: Krassi
authors.initials: K
authors.lastname: Ivancev
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Resch
authors.forename: Björn
authors.initials: B
authors.lastname: Sonesson
authors.forename: Martin
authors.initials: M
authors.lastname: Malina
mesh_terms: 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