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Triple Arch Branch Repair Under Sedo-Analgesia.

Martina Bastianon^1,2, Jan Stana^1,2, Nikolaos Konstantinou^1,2

¹University Aortic Center Munich, LMU University Hospital, Munich, Germany.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists

|April 22, 2025

Summary

Triple arch branch repair under sedo-analgesia is a safe option for high-risk patients with severe chronic obstructive pulmonary disease (COPD). This approach avoids general anesthesia and intubation, reducing postoperative complications in patients with pulmonary compromise.

Keywords:

COPD anesthesia aneurysm aortic arch aortic arch aneurysm endovascular aneurysm repair endovascular arch repair sedo-analgesia thoracic aortic aneurysm triple branch arch

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Area of Science:

Vascular Surgery
Thoracic Endovascular Aortic Repair

Background:

High-risk patients often have severe chronic obstructive pulmonary disease (COPD).
COPD increases risks associated with general anesthesia and intubation for aortic arch surgery.
Traditional open surgery may be contraindicated in these patients.

Purpose of the Study:

To describe the technical aspects of triple arch branch repair under sedo-analgesia.
To evaluate the feasibility of this approach in a patient with severe COPD unsuitable for intubation.

Main Methods:

A clinical case of triple arch branch repair is presented.
The procedure was performed under sedo-analgesia, avoiding general anesthesia and intubation.
Focus on precise graft deployment techniques.

Main Results:

Successful triple arch branch repair was achieved under sedo-analgesia.
The patient experienced no postoperative complications.
Precise graft deployment was confirmed.

Conclusions:

Triple arch branch repair under sedo-analgesia is a viable alternative for high-risk patients with severe pulmonary compromise.
This technique obviates the need for general anesthesia and intubation.
Further studies are needed to validate the safety and efficacy of this approach.