• Cherrie Z Abraham and Christos Lioupis.
• Division of Vascular Surgery, Department of Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada. cherriezack@gmail.com
• J. Thorac. Cardiovasc. Surg.. 2013 Mar 1;145(3 Suppl):S110-7.

ObjectiveTo present an initial experience with a new modular transfemoral multibranched stent-graft for treating aortic arch aneurysms.MethodsSix patients, considered high risk for open surgery, were treated with a custom-made branched stent-graft. Two patients had aortic arch aneurysms, three had descending thoracic aortic aneurysms involving the distal arch, and one had a saccular aneurysm of the arch adjacent to the origin of the innominate artery. All patients had undergone a staged left carotid subclavian bypass before the endovascular procedure. Each branched graft had a 12-mm side branch for the innominate artery and an 8-mm side branch for the left common carotid artery. The branches were extended into their respective target arteries with covered self-expanding stents.ResultsAneurysm exclusion without endoleak was successful in 5 of the 6 patients, and 11 of the 12 target vessels were successfully cannulated and preserved. Patient 1 developed a type I endoleak that was managed successfully with coiling and gluing of the aneurysm sac. Patients 2, 3, 5, and 6 had uneventful placement of the prostheses, with successful exclusion of the aneurysm sac. In patient 4, cannulation of the innominate branch was unsuccessful, and an extra-anatomic bypass was necessary to perfuse the right carotid and vertebral arteries.ConclusionsWe have demonstrated the technical feasibility of a modular transfemoral branched stent-graft for treatment of aortic arch aneurysms. Our initial experience has shown that the method is relatively safe. Long-term follow-up is necessary to evaluate the efficacy and safety of this new device.Copyright © 2013. Published by Mosby, Inc.

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