A novel technique for hybrid aortic arch reconstruction: the deployment cuff technique

Extensive thoracic aortic aneurysmal disease involving the arch and descending aorta has been a difficult problem. The "frozen elephant trunk" single-stage procedure combining open arch repair under circulatory arrest with a deployment of a stented thoracic endograft has shown good results in recent reports, but it can be technically challenging to deploy the endovascular device in the exact location. In patients with aortic dissection, back bleeding through the false lumen necessitates obliteration of the false lumen proximally. We describe a technique that allows for precise deployment and obliteration of false lumen flow at the proximal end of the stent graft.