title: Preloaded guidewires to facilitate endovascular repair of thoracoabdominal aortic aneurysm using a physician-modified branched stent graft.
abstract: Branched stent grafts have been widely applied to treat complex aortic aneurysms. The technique often requires brachial or axillary approach to provide antegrade access to directional branches, which are bridged to target visceral arteries by self-expandable stent grafts. Preloaded guidewire catheterization may facilitate access into directional branches, decreasing or eliminating catheter manipulations required during this step of the procedure. We describe the use of a physician-modified branched stent graft using preloaded guidewire catheterization to treat a patient with recurrent, type III thoracoabdominal aortic aneurysm. The procedure was performed with no complications, and total operative time was 300 minutes, fluoroscopy time was 81 minutes, and iodinated contrast dose was 210 mL. Computed tomographic angiography revealed no endoleak and widely patent branches at 2 months.
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn. Electronic address: oderich.gustavo@mayo.edu.
authors.forename: Gustavo S
authors.initials: GS
authors.lastname: Oderich
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn.
authors.forename: Bernardo C
authors.initials: BC
authors.lastname: Mendes
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn.
authors.forename: Mateus P
authors.initials: MP
authors.lastname: Correa
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D062666:Vascular Access Devices; D014654:Vascular Patency