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

Yasmeen Dhindsa, MD; Alexander DiBartolomeo, MD; Gregory A. Magee, MD, MSc; Fernando Fleischman, MD; Sukgu M. Han, MD, MS

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

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

Yasmeen Dhindsa, MD,
Alexander DiBartolomeo, MD,
Gregory A. Magee, MD, MSc,
Fernando Fleischman, MD,
Sukgu M. Han, MD, MS

Affiliations

Yasmeen Dhindsa, MD: Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA
Alexander DiBartolomeo, MD: Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA
Gregory A. Magee, MD, MSc: Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA
Fernando Fleischman, MD: Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA
Sukgu M. Han, MD, MS: Correspondence: Sukgu M. Han, MD, MS, Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, 1520 San Pablo St, Ste 4300, Los Angeles, CA 90033; Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA

Journal volume & issue: Vol. 9, no. 4
p. 101289

Abstract

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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.

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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