Incorporation of Celiomesenteric Trunk With Double Kissing Directional Branches During Fenestrated-Branched
Giulianna B Marcondes1, Emanuel R Tenorio1, Guilherme B Lima1
1Advanced Aortic Research Program, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA.
Purpose:
Common celiomesenteric trunk (CMT) is a rare anatomical variation that occurs in 0.5% to 3.4% of the general population. Its presence may complicate planning and implantation of fenestrated and branched stent-grafts because the wide diameter and short length of the CMT to its bifurcation does not allow sufficient sealing for placement of bridging stents.
Case Report:
We report a patient with thoracoabdominal aortic aneurysm (TAAA) and CMT treated by fenestrated-branched endovascular aortic repair (FB-EVAR) using double kissing directional branches to incorporate the celiac axis and superior mesenteric artery. Pitfalls of stent design and implantation are outlined.
Conclusion:
Double kissing directional branches should be considered as an alternative to incorporate vessels with early bifurcation such as a CMT.
