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

doi:10.1177/1526602819890108

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

Vascular and Endovascular Surgery

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	124-129
Number of pages	6
Journal	Journal of Endovascular Therapy
Volume	27
Issue number	1
DOIs	https://doi.org/10.1177/1526602819890108
State	Published - Feb 1 2020

Keywords

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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10.1177/1526602819890108

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

abstract = "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.",

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AU - D’Oria, Mario

AU - Mirza, Aleem K.

AU - Tenorio, Emanuel R.

AU - Kärkkäinen, Jussi M.

AU - DeMartino, Randall R.

AU - Oderich, Gustavo S.

N1 - Publisher Copyright: © The Author(s) 2019.

PY - 2020/2/1

Y1 - 2020/2/1

N2 - 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.

AB - 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.

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KW - surgeon-modified stent-graft

KW - target artery

KW - thoracic endovascular aortic repair

KW - thoracoabdominal aortic aneurysm

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

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