title: Endovascular aortic arch reconstruction using in situ stent-graft fenestration in the brachiocephalic artery.
abstract: A patient who had previously undergone retrosternal gastric tube reconstruction for esophageal cancer presented with an aortic arch aneurysm. The patient was treated with endovascular stent-graft placement without median sternotomy, followed by revascularization of the brachiocephalic trunk using percutaneous in situ graft fenestration. A 9-month follow-up examination revealed marked regression of the aneurysm with patency of the stent-graft, without any complications. This in situ fenestration technique may extend the limits of thoracic endovascular therapy for patients who are unsuitable for sternotomy or aortic side-clamping.
authors.affiliation: Department of Radiology, Oita University Faculty of Medicine, Idaigaoka Hasama-machi, Yufu-shi, Oita, Japan. hongou@oita-u.ac.jp
authors.forename: Norio
authors.initials: N
authors.lastname: Hongo
authors.forename: Shinji
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Rieko
authors.initials: R
authors.lastname: Shuto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Wada
authors.forename: Shunro
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Hiro
authors.initials: H
authors.lastname: Kiyosue
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
mesh_terms: D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D014057:Tomography, X-Ray Computed