Three-vessel fenestrated repair of 6-cm thoracoabdominal aortic aneurysm repair after chronic type B dissection.

Abstract

Experience with fenestrated endovascular aortic endograft (FEVAR) in the treatment of post dissection aneurysms remains challenging. A 49-year-old male with a history of type A dissection repair (ascending tube graft) presented with a residual 6-cm expanding extent III thoracoabdominal aortic aneurysm (TAAA). Our objective was to perform a 3-vessel FEVAR with a custom-made endograft with preloaded wires for each fenestration. Serial deployment technique was utilized. This technique allowed us to cannulate each target artery from above while keeping the rest of the fenestrated endograft below each fenestration still in the sheath.