Sandwich thoracic branch endoprosthesis technique for endovascular repair of thoracic aortic aneurysm with aberrant right subclavian artery

Yasmeen Dhindsa; Alexander DiBartolomeo; Gregory A Magee; Fernando Fleischman; Sukgu M Han

doi:10.1016/j.jvscit.2023.101289

Sandwich thoracic branch endoprosthesis technique for endovascular repair of thoracic aortic aneurysm with aberrant right subclavian artery

J Vasc Surg Cases Innov Tech. 2023 Aug 9;9(4):101289. doi: 10.1016/j.jvscit.2023.101289. eCollection 2023 Dec.

Authors

Yasmeen Dhindsa¹, Alexander DiBartolomeo¹, Gregory A Magee¹, Fernando Fleischman¹, Sukgu M Han¹

Affiliation

¹ Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA.

Abstract

Subclavian artery coverage is frequently required to achieve an adequate proximal seal during thoracic endovascular aortic repair. The thoracic branch endoprosthesis (TBE; W.L. Gore & Associates) is the first U.S. Food and Drug Administration-approved branched device for thoracic endovascular aortic repair, designed for left subclavian artery incorporation. However, anatomic suitability of the TBE has been shown to be limited. In the present report, we describe a novel technique using the TBE in a sandwich periscope configuration to allow for emergent repair of a ruptured thoracic aortic aneurysm with a highly angulated proximal seal zone and aberrant right subclavian artery.

Keywords: Ruptured thoracic aortic aneurysm; Thoracic branch endograft; Thoracic endovascular aortic repair.