Thoracic Endovascular Aortic Repair for Aortic Arch Aneurysms Using Physician-Modified Endovascular Graft with Pre-Crossing Cannulated Wires for the Left Common Carotid Artery Aortic Arch Aneurysms

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Regarding thoracic endovascular aortic repair involving the aortic arch, fenestration is occasionally employed to maintain blood flow to aortic branches. Pre-cannulation can mitigate the risk of misalignment between the left subclavian artery fenestration and arch branches. However, the left common carotid artery is located in a tortuous area of the arch, making fenestration alignment difficult. We employed a novel pre-cannulation technique to prevent such misalignment in a 73-year-old patient. This technique represents a systematic approach to left common carotid artery fenestration alignment in thoracic endovascular aortic repair, with potential reproducibility in selected cases. This approach requires validation in larger cohorts.