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Rescue of a Failing Endovascular Infrarenal Aortic Repair Using an Off-The-Shelf Branched Endograft
Gino Gemayel1, Gabriel Verdon1, Nicolas Murith1
1Cardiovascular Surgery Department, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Background:
Proximal aortic dilation following open and endovascular aortic repair (EVAR) is a well-known phenomenon. If severe enough, it may lead to late onset of type Ia endoleak that jeopardizes the proximal seal.
Methods:
We report the case of a patient previously treated by EVAR for an infrarenal aneurysm who developed a type Ia endoleak after proximal aortic dilation. His aneurysms enlarged to 10 cm mandating a rapid repair without the delay for a custom-made device.
Results:
We successfully used the off-the-shelf thoracic t-Branch graft (Cook, Bloomington, IN) with its 4 branches to treat the dilated aorta and seal the endoleak.
Conclusion:
The off-the-shelf t-Branch is a useful option in patient with previous EVAR presenting with proximal aortic dilation and endoleak who cannot wait for a custom-made device.
