Volume 25, Issue 5, Pages e38-e41 (May 2013)

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Presentation transcript:

Volume 25, Issue 5, Pages e38-e41 (May 2013) Aortic-arch Reconstruction with Bolton Medical Branched Thoracic Stent Graft L. Botta, P. Fratto, A. Cannata, G. Bruschi, A. Rampoldi, L. Martinelli EJVES Extra Volume 25, Issue 5, Pages e38-e41 (May 2013) DOI: 10.1016/j.ejvsextra.2012.12.005 Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 1 Case imaging. Preoperative angio-CT scan of the thoracic aorta showed a PAU immediately after the left subclavian artery (white arrow in A). Supra-aortic vessels originated from the arch, very close to each other (A). The angiographic control at the end of procedure showed a good result, absence of endoleaks and no prosthetic migration (B). CT-scan performed at discharge showed PAU thrombosis (C), patency of CCB (D), correct positioning of the branched stent-graft (C and E), thrombosis of the left common proximal carotid artery, patency of LSA due to retrograde perfusion in absence of significant endoleaks (E). CT-scan reconstruction of the thoracic aorta was performed after 1-year follow-up and confirmed a satisfactory result (F). EJVES Extra 2013 25, e38-e41DOI: (10.1016/j.ejvsextra.2012.12.005) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 2 The new branched stent-graft system. A silicon 3-dimensional model, exactly corresponding to the patient's aorta, was manufactured by Bolton Medical (A). In-vitro deployment and orientation tests were performed (B). In C, the main body stent-graft (46/34 mm × 220 mm, proximal and distal Crown stent, NBS Plus delivery system) is indicated by a black asterisk and the proximal stent-graft for the ascending aorta by a white asterisk. A tunnel of 15 mm in diameter (white arrow in D and E) was added to the main body, directly connected with a 30 mm × 30 mm fenestration (black arrow in C, superior view point). A limb extension was inserted into the main body tunnel to preserve blood flow in the innominate artery (gray arrow in E). EJVES Extra 2013 25, e38-e41DOI: (10.1016/j.ejvsextra.2012.12.005) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions