Innovative sandwich technique in treating a symptomatic saccular suprarenal aneurysm involving the celiac trunk

To describe a new technique that combines traditional stent graft and multiple overlapping uncovered stents to form a sandwich-like structure in the management of a wide-necked saccular suprarenal aneurysm.

An 83-year-old woman was admitted to the hospital with a large symptomatic aortic aneurysm that involved celiac trunk. Traditional stent graft and coiling were precluded due to the anatomical complexity of the aneurysm. A novel combination of multiple overlapping stents and grafted stents was utilized in this patient in order to maximally reduce the blood flow into the sac and to preserve visceral branches. At 3-month follow-up, patent celiac artery and superior mesenteric artery along with complete shrinkage of aneurismal sac were documented.

The combination of grafted stents and uncovered stents can effectively reduce velocity and volume of blood flow into the aneurismal sac, which induces thrombosis within the sac, while all the branches could be preserved.