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Updated: Oct 22, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Use of Physician-Modified Fenestrated Stent-Graft With Wire Loop Technique for Complex Aortic Arch Aneurysm
1Department of vascular surgery, Drum tower Hospital, affiliated to school of medicine, Nanjing University, Nanjing, China; Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Background:
To present a novel means of overcoming a deviation when treating an aortic arch aneurysm with a physician-modified fenestrated stent-graft.
Methods:
A 78-year-old man showed a rapidly expanding aortic arch aneurysm, and the limited landing zone required the use of a fenestrated/branched arch endograft. Physician-modified fenestrated stent-grafts are considered suitable for patients in an acute setting. The device became malrotated in a clockwise direction during deployment; therefore, cannulation of the first inner branch using a through-and-through wire technique was needed. The final angiogram showed a good result.
Conclusion:
Thoracic endovascular repair of an aortic arch aneurysm using a through-and-through technique can be considered for high-risk patients in an acute setting.

