title: Complete endovascular debranching of the aortic arch: A report of two cases.
abstract: Patients suffering from aortic arch aneurysms continue to encounter few treatment options. Because of co-morbidities, most are deemed to not be open surgical candidates. The two cases presented here demonstrate a novel endovascular approach in the care of an arch aneurysm complicated by dissection. Even though final graft configurations differed slightly between the two cases, all three great vessels were successfully de-branched through the combination of standard endovascular aneurysm repair techniques and modifications to off-the-shelf devices. Aortic flow was compartmentalized in the ascending aorta at or near the level of the sinotubular junction. This was done with a physician-assembled endografts. One of these lumens was dedicated to the descending aorta, while the other was further divided into three channels used to stent the great vessels. Completion angiography demonstrated patency in the arch, great vessels, and descending aorta. No endoleaks have been reported. Although data is limited, this approach appears promising.
authors.affiliation: Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Sanford Health, Sanford Vascular Associates, Sioux Falls, SD, USA.
authors.forename: Madeline
authors.initials: M
authors.lastname: Nykamp
authors.affiliation: Sanford Health, Sanford Vascular Associates, Sioux Falls, SD, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Remund
authors.affiliation: Sanford Health, Sanford Vascular Associates, Sioux Falls, SD, USA Patrick.kelly@sanfordhealth.org.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kelly
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome
keywords: Aortic arch aneurysm; endovascular aneurysm repair; endovascular de-branch; great vessels; off-the-shelf devices; thoracic manifold