title: New Advances in Endovascular Therapy: Endovascular Repair of a Chronic DeBakey Type II Aortic Dissection With a Scalloped Stent-Graft Designed for the Ascending Aorta.
abstract: OBJECTIVE
  To describe the deployment into the ascending aorta of a fenestrated stent-graft with a scallop for the innominate artery.
  
  
  METHODS
  A 72-year-old multimorbid patient presented with a chronic DeBakey type II aortic dissection of the ventral ascending aorta with close proximity (16 mm) to the innominate artery. A 1-piece, 46-mm-diameter Zenith Ascend Thoracic Endovascular Graft with circumferential diameter-reducing sutures (ProForm) was custom made with a 15×30-mm scallop for the innominate artery. The stent-graft was loaded on a Z-Trak Plus Introducer System with a 20-F hydrophilic-coated sheath and successfully implanted under inflow occlusion in a procedure that lasted 35 minutes.
  
  
  CONCLUSIONS
  The use of fenestrated stent-grafts in the ascending aorta is feasible, and a scallop in the distal stent-graft can extend coverage of the ascending aorta in pathologies close to the innominate artery. This technique broadens the range of endovascular options for patients not suitable for open surgery.
authors.affiliation: Department of Vascular Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany f.rohlffs@uke.de.
authors.forename: Fiona
authors.initials: F
authors.lastname: Rohlffs
authors.affiliation: Department of Vascular Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimparis
authors.affiliation: Department of Cardiothoracic Surgery, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Detter
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Yskert
authors.initials: Y
authors.lastname: von Kodolitsch
authors.affiliation: Department of Vascular Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Debus
authors.affiliation: Department of Vascular Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery*; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: aortic dissection; ascending aorta; fenestrated stent-graft; innominate artery; scalloped stent-graft; thoracic endovascular aortic repair; type B dissection