Physician-Modified Endograft With Double Inner Branches for Urgent Repair of Supraceliac Para-Anastomotic Pseudoaneurysm

Mario D’Oria, Aleem K. Mirza, Emanuel R. Tenorio, Jussi M. Kärkkäinen, Randall R. DeMartino, Gustavo S. Oderich

Research output: Contribution to journalArticle

2 Scopus citations


Purpose: To demonstrate the feasibility of a physician-modified endograft (PMEG) with inner branches for 2 mesenteric arteries as an alternative to fenestrations or directional branches. Technique: A symptomatic 60-year-old man presented with supraceliac para-anastomotic pseudoaneurysm involving an antegrade aorta to celiac artery and superior mesenteric artery bypass. Since an off-the-shelf multibranched endograft was inappropriate, a Zenith Alpha thoracic stent-graft was modified with 2 inner branches fashioned of 8-mm Viabahn endoprostheses with preloaded guidewires. The procedure was technically successful, and the patient had no postoperative complications. Conclusion: Inner branches might offer an alternative to fenestrations or directional branches in patients with narrow aortas.

Original languageEnglish (US)
JournalJournal of Endovascular Therapy
StateAccepted/In press - Jan 1 2019



  • branched stent-graft
  • fenestrated stent-graft
  • inner branches
  • para-anastomotic aneurysm
  • physician-modified stent-graft
  • renovisceral vessels
  • surgeon-modified stent-graft
  • target artery
  • thoracic endovascular aortic repair
  • thoracoabdominal aortic aneurysm

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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