How to occlude a side branch on a branched stent-graft during an endovascular thoracoabdominal aortic aneurysm repair.

Objective: To present a means of occluding an unneeded side branch during deployment of custom-made branched stent-grafts for thoracoabdominal aortic aneurysm (TAAA) repair.

Methods: When a side branch on a customized TAAA branched stent-graft is not needed, an oversized Amplatzer Vascular Plug II can be deployed inside the side branch after the other visceral artery branches have been deployed. The plug's distal disk is placed into the side branch from the aortic lumen, as though it were a bottle cap. Pulling the device backward deploys the remainder of the body inside the 18-mm-long side branch. The result is immediate and satisfactory.

Conclusions: This technique should be known to any team performing TAAA repair with branched stent-grafts. It may also serve as a means of fitting a stent-graft to a different patient in an emergency setting, as in the case illustrated here.