Thoracic endograft placement using a transfemoral snare in a patient with angled aortic arch

Abstract

In complex anatomical challenges, endovascular endograft implantation to the thoracic aorta may not be performed. Various techniques have been put forward for endograft therapy. In this report, we present the effect of femoral snare support for a patient with an aortic arch angle. Thoracic endovascular aneurysm repair (TEVAR) was used for treating a 60-year-old male patient who suffered from severe angulation in the arcus aorta and aneurysmal enlargement of the left subclavian artery and descending aorta. The endovascular graft could not be advanced into the aortic arch with the guidewire because of the aortic arch angle. Therefore, the TEVAR graft distal end was caught with the snare advanced from the femoral artery, and the TEVAR graft was advanced into the aortic arch. The femoral snare technique is a simple and successful method for endograft implantation of the aortic arch disease without the risk of heart trauma, especially in cases with aortic arch tortuosity.