Triple Arch Branch Repair Under Sedo-Analgesia

Triple arch branch repair has emerged as a feasible option for high-risk patients unsuitable for open surgery. In high-risk patients, severe pulmonary compromise of pulmonary function due to chronic obstructive pulmonary disease (COPD) can be found. This condition is associated with a higher risk of postoperative complications after general anesthesia and intubation.

In this clinical case, we describe the technical aspects of triple arch branch repair under sedo-analgesia, in a patient with severe COPD, unsuitable for intubation. Precise graft deployment was obtained, and no postoperative complications occurred.

Triple arch branch repair under sedo-analgesia emerges as a viable option for high-risk patients with severe pulmonary compromise, obviating the need for general anesthesia and intubation. This clinical case elucidates the procedure, accentuating both its advantages and limitations, while suggesting the necessity for further validation of its safety in future studies.Clinical ImpactThe execution of complex endovascular aortic arch repair under sedo-analgesia allows for the expanded applicability of these techniques even in high-risk patients who, due to respiratory issues, cannot undergo general anesthesia and intubation.