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Aortic arch aneurysm repair with a new branched device

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1 Aortic arch aneurysm repair with a new branched device
Gabriele Piffaretti, MD, PhD, Nicola Rivolta, MD, Federico Fontana, MD, Gianpaolo Carrafiello, MD, Giovanni Mariscalco, MD, PhD, Patrizio Castelli, MD  Journal of Vascular Surgery  Volume 57, Issue 6, Pages (June 2013) DOI: /j.jvs Copyright © 2013 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Preliminary computed tomography (CT) angiograms showing the normal ascending aorta (A1), the takeoff of the left vertebral artery from the arch (arrow, A2), and the aneurysm (A3). Three-dimensional reconstruction shows the location of the arch aneurysm and synchronous presence of an ectatic infrarenal aorta (A4). Postoperative CT angiogram at 1 month showing the normal ascending aorta (B1) and the good apposition of the endograft with the patency of the branch (B2 and B3). Three-dimensional reconstruction of the branched endograft with complete exclusion of the aneurysm shows the patency of the innominate branch as well as of the carotid bypass graft (B4). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Manufacturing details of the endograft: internal tunnel (A1) and the wide window that hosts the internal tunnel (A2 and A3). Fluoroscopic bench tests revealed the visible radiopaque markers (arrows) delimiting the wide tunnel pocket aligned in front of the innominate artery and the left common carotid artery (A4). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Intraoperative images: preliminary angiogram (A1), angiogram obtained after deployment of the endograft (A2), and final control angiogram (A3) with perfusion of both the innominate artery and the left common carotid artery, as well as of the bypass grafts, and complete exclusion of the sac without signs of endoleak. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

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