Technical Aspects of Implanting the t-Branch Off-the-Shelf Multibranched Stent-Graft for Thoracoabdominal Aneurysms.
To describe the planning and technique for implantation of the t-Branch off-the-shelf multibranched aortic endograft.



Total endovascular repair of thoracoabdominal aneurysms (TAAAs) with branched endografts is one of the most important paradigm shifts in the past decade. The t-Branch endograft, an off-the-shelf multibranched graft introduced in the European market in late 2012, allows treatment of patients with suitable anatomy in both the elective and urgent settings to avoid delays related to manufacturing time of custom-made devices. The steps required for the planning and implantation of the device are described, including some tips and tricks.



The use of an off-the-shelf multibranched device is an appealing option in the treatment of TAAAs, especially in the acute setting. Nevertheless, results of complex aortic repairs with this specific device are associated with a learning curve and can be improved by identifying a number of intraoperative risks and paying heed to several technical details.
1 Department of Vascular Medicine, German Aortic Center, Hamburg, Germany.
Nikolaos
N
Tsilimparis
1 Department of Vascular Medicine, German Aortic Center, Hamburg, Germany.|2 Unit of Vascular Surgery, Ospedale S. Maria della Misericordia, University of Perugia, Italy.
Beatrice
B
Fiorucci
1 Department of Vascular Medicine, German Aortic Center, Hamburg, Germany.
Eike Sebastian
ES
Debus
1 Department of Vascular Medicine, German Aortic Center, Hamburg, Germany.
Fiona
F
Rohlffs
1 Department of Vascular Medicine, German Aortic Center, Hamburg, Germany.
Tilo
T
Kölbel
D015901:Angiography, Digital Subtraction; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002983:Clinical Competence; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D059032:Learning Curve; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
branched stent-graft; descending thoracic aorta; endograft; endovascular aneurysm repair; endovascular treatment/therapy; implantation technique; off-the-shelf device; stent-graft; thoracoabdominal aortic aneurysm