Early Tip Capture Release and Push-Up Technique Using the Valiant Stent Graft System for Aortic Arch Aneurysms

During thoracic endovascular aneurysm repair for aortic arch aneurysms, deployment of the stent graft parallel to the aortic neck is crucial to preventing a type Ia endoleak from the proximal end. We report the early tip capture release and push-up technique that comprises early release of the proximal bare stent, which is typically deployed last during stent graft deployment, followed by a push-up maneuver after landing the proximal edge, thus allowing conformation to the aortic morphology. This technique is effective even for complex aortic arch anatomy.