• C Lioupis, M-M Corriveau, K S MacKenzie, D I Obrand, O K Steinmetz, and C Z Abraham.
• McGill University, Division of Vascular Surgery, Jewish General Hospital, 3755 Cote-Ste-Catherine, Montreal, QC H3T1E2, Canada. christoslioupis@yahoo.gr
• Eur J Vasc Endovasc Surg. 2012 May 1;43(5):525-32.

ObjectivesTo present 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 custom made branched stent grafts. All patients had 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.ResultsFour patients out of six had uneventful placement of the prostheses, with successful exclusion of their aneurysms. One patient developed a type I endoleak that was managed successfully with coiling and gluing of the aneurysm sac. In one patient, cannulation of the innominate branch was unsuccessful and an extra-anatomic bypass was necessary to perfuse the right carotid and vertebral arteries. This patient developed a stroke, while one more suffered a right cerebellar infarct.ConclusionWe have demonstrated the technical feasibility of a modular transfemoral branched stent graft for treatment of aortic arch aneurysms. The method is relatively safe based on initial experience. More cases and long-term follow up are necessary to evaluate the efficacy and safety of this new device.Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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