Custom Endovascular Repair of an Aortic Arch Aneurysm After Coronary Artery Bypass Grafting

Aortic arch pathology is traditionally treated via open methods involving arch or hemiarch replacement. Advances in transcatheter endograft technology have provided a minimally invasive alternative in selected cases.

We herein describe the case of a 75-year-old man with an aortic arch aneurysm on the background of a previous coronary artery bypass graft involving a left internal mammary artery-to-left anterior descending artery (LIMA-LAD) graft, who was treated with a Bolton Relay custom scalloped stent graft.

This case highlights the feasibility of endografts in the setting of a LIMA-LAD graft and the importance of detailed preoperative planning within a multidisciplinary approach.

Custom thoracic endovascular aortic repair is a safe alternative to open surgery in the treatment of aortic arch aneurysm in high-risk patients with a LIMA-LAD graft.