How to occlude a side branch on a branched stent-graft during an endovascular thoracoabdominal aortic aneurysm repair.
OBJECTIVE
To present a means of occluding an unneeded side branch during deployment of custom-made branched stent-grafts for thoracoabdominal aortic aneurysm (TAAA) repair.


METHODS
When a side branch on a customized TAAA branched stent-graft is not needed, an oversized Amplatzer Vascular Plug II can be deployed inside the side branch after the other visceral artery branches have been deployed. The plug's distal disk is placed into the side branch from the aortic lumen, as though it were a bottle cap. Pulling the device backward deploys the remainder of the body inside the 18-mm-long side branch. The result is immediate and satisfactory.


CONCLUSIONS
This technique should be known to any team performing TAAA repair with branched stent-grafts. It may also serve as a means of fitting a stent-graft to a different patient in an emergency setting, as in the case illustrated here.
Ferreira
Marcelo
M
SITE - Serviço Integrado de Técnicas Endovasculares, Rio de Janeiro, Brazil. marceloferreira@siteendovascular.com
Monteiro
Marcelo
M
Lanziotti
Luiz
L
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000473:pathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000473:pathology; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002445:Celiac Artery / Q000473:pathology; D004638:Emergency Treatment; D006801:Humans; D008297:Male; D018579:Patient Selection; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome