title: Treatment of aortic arch aneurysms with a modular transfemoral multibranched stent graft: initial experience.
abstract: OBJECTIVE
  To present initial experience with a new modular transfemoral multibranched stent graft for treating aortic arch aneurysms.
  
  
  METHODS
  Six patients, considered high risk for open surgery, were treated with custom made branched stent grafts. All patients had a staged left carotid subclavian bypass before the endovascular procedure. Each branched graft had a 12 mm side branch for the innominate artery and an 8 mm side branch for the left common carotid artery.
  
  
  RESULTS
  Four patients out of six had uneventful placement of the prostheses, with successful exclusion of their aneurysms. One patient developed a type I endoleak that was managed successfully with coiling and gluing of the aneurysm sac. In one patient, cannulation of the innominate branch was unsuccessful and an extra-anatomic bypass was necessary to perfuse the right carotid and vertebral arteries. This patient developed a stroke, while one more suffered a right cerebellar infarct.
  
  
  CONCLUSIONS
  We have demonstrated the technical feasibility of a modular transfemoral branched stent graft for treatment of aortic arch aneurysms. The method is relatively safe based on initial experience. More cases and long-term follow up are necessary to evaluate the efficacy and safety of this new device.
authors.affiliation: McGill University, Division of Vascular Surgery, Jewish General Hospital, 3755 Cote-Ste-Catherine, Montreal, QC H3T1E2, Canada. christoslioupis@yahoo.gr
authors.forename: C
authors.initials: C
authors.lastname: Lioupis
authors.forename: M-M
authors.initials: MM
authors.lastname: Corriveau
authors.forename: K S
authors.initials: KS
authors.lastname: MacKenzie
authors.forename: D I
authors.initials: DI
authors.lastname: Obrand
authors.forename: O K
authors.initials: OK
authors.lastname: Steinmetz
authors.forename: C Z
authors.initials: CZ
authors.lastname: Abraham
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D015607:Stents