Use of retrograde left subclavian branch portal of Gore TAG thoracic branch endoprosthesis for physician-modified fenestrated branched endovascular repair of thoracoabdominal aortic aneurysm

Alexander D. DiBartolomeo, MD; Elizabeth Miranda, MD, MPH; Alyssa J. Pyun, MD; Fernando Fleischman, MD; Gregory A. Magee, MD, MSc; Sukgu M. Han, MD, MS

Journal of Vascular Surgery Cases and Innovative Techniques (Jun 2023)

Use of retrograde left subclavian branch portal of Gore TAG thoracic branch endoprosthesis for physician-modified fenestrated branched endovascular repair of thoracoabdominal aortic aneurysm

Alexander D. DiBartolomeo, MD,
Elizabeth Miranda, MD, MPH,
Alyssa J. Pyun, MD,
Fernando Fleischman, MD,
Gregory A. Magee, MD, MSc,
Sukgu M. Han, MD, MS

Affiliations

Alexander D. DiBartolomeo, MD: Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California, Los Angeles, CA
Elizabeth Miranda, MD, MPH: Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California, Los Angeles, CA
Alyssa J. Pyun, MD: Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California, Los Angeles, CA
Fernando Fleischman, MD: Division of Cardiothoracic Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA
Gregory A. Magee, MD, MSc: Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California, Los Angeles, CA
Sukgu M. Han, MD, MS: Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California, Los Angeles, CA; Correspondence: Sukgu M. Han, MD, MS, Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California, 1520 San Pablo St, HCT 4300, Los Angeles, CA 90033

Journal volume & issue: Vol. 9, no. 2
p. 101135

Abstract

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A 75-year-old man who had undergone zone 2 thoracic endovascular repair of a symptomatic penetrating aortic ulcer using a Gore TAG thoracic branch endoprosthesis (TBE) device (W.L. Gore & Associates) 5 years before had presented with an enlarging extent I thoracoabdominal aortic aneurysm. A physician-modified five-vessel fenestrated-branched endograft repair was performed using preloaded wires. The visceral renal vessels were sequentially catheterized from the left brachial access via the TBE portal, and the endograft was deployed in staggered fashion. At 1 year of follow-up, imaging studies demonstrated a stable aneurysm sac, patent visceral renal branches, and no endoleak. The retrograde portal of Gore TAG TBE can facilitate fenestrated-branched endovascular repair of thoracoabdominal aortic aneurysms.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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