Physician Modification to Shorten a TAG Thoracic Endoprosthesis for Treatment of a Pseudoaneurysm in the Ascending Aorta.

Abstract

PURPOSE:

To report initial use of a physician-modified Gore TAG Thoracic Endoprosthesis for the treatment of pseudoaneurysm in the ascending aorta.

TECHNIQUE:

This technique is demonstrated in a 42-year-old man with a pseudoaneurysm of the ascending aorta after a Bentall operation. The treatable length extending from the sinotubular junction to the anastomotic aneurysm edge was only 5 cm. A 45×100-mm TAG endograft for the pseudoaneurysm was modified on a back table to shorten its length. The delivery shaft was incised, and the 2 threads that fasten the top and bottom portions of the stent-graft to the sleeve were pulled out. The unfolded half of the stent-graft was cut back after pulling out the strand for the back half. Next, this custom-made graft was deployed via a transcarotid approach with cardiopulmonary bypass; no endoleak was observed. Postoperative computed tomography showed a minute type Ib endoleak. The patient was doing well at postoperative month 6.

CONCLUSION:

Physician modification of a TAG endograft facilitated effective management of this ascending aortic lesion by shortening the length of aortic coverage.

• Authors: Kenji Wada, Takeshi Shimamoto, Tatsuhiko Komiya, Hiroshi Tsuneyoshi
• Journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 23 Issue 3 Pg. 489-92 (Jun 2016) ISSN: 1545-1550 [Electronic] United States
• PMID: 27099282 (Publication Type: Case Reports, Journal Article)
• Copyright: © The Author(s) 2016.

Topics

• Adult
• Aneurysm, False (diagnostic imaging, etiology, surgery)
• Aortic Aneurysm (diagnostic imaging, etiology, surgery)
• Aortography (methods)
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (instrumentation)
• Endovascular Procedures (instrumentation)
• Humans
• Male
• Marfan Syndrome (complications, diagnosis)
• Physician's Role
• Prosthesis Design
• Stents
• Time Factors
• Tomography, X-Ray Computed
• Treatment Outcome