Endovascular repair of a thoracic arch aneurysm with a fenestrated stent-graft.

Objective: To report a new endovascular technique for thoracic aortic arch aneurysm repair with a fenestrated stent-graft.

Methods: A 75-year-old man presented with a 5.5-cm thoracic aneurysm involving the inner curve and left anterior lateral aspect of the aortic arch. The innominate and left carotid arteries shared a common trunk, and the right vertebral artery was dominant. Endovascular repair was performed utilizing a fenestrated stent-graft that allowed perfusion of the innominate and left carotid arteries but occluded the left subclavian artery. At 8 months post procedure, the patient is well; imaging documented the continued exclusion of the aneurysm and perfusion of the common trunk branches.

Conclusions: Fenestrated endovascular grafts for specific thoracic aortic arch aneurysm can be used safely in the high-risk patient.