Endovascular repair of a thoracic arch aneurysm with a fenestrated stent-graft.

PURPOSE

To report a new endovascular technique for thoracic aortic arch aneurysm repair with a fenestrated stent-graft.

CASE REPORT

A 75-year-old man presented with a 5.5-cm thoracic aneurysm involving the inner curve and left anterior lateral aspect of the aortic arch. The innominate and left carotid arteries shared a common trunk, and the right vertebral artery was dominant. Endovascular repair was performed utilizing a fenestrated stent-graft that allowed perfusion of the innominate and left carotid arteries but occluded the left subclavian artery. At 8 months post procedure, the patient is well; imaging documented the continued exclusion of the aneurysm and perfusion of the common trunk branches.

CONCLUSION

Fenestrated endovascular grafts for specific thoracic aortic arch aneurysm can be used safely in the high-risk patient.