PMC8556512_01
Three dimensional reconstruction of the pre-operative computed tomography angiogram. (A) Kieffer type B innominate artery aneurysm (IAA) and left subclavian ectasia. (B) Sagittal transection through the aortic arch and IAA. Note the mural thrombosis and the tortuous course of the descending aorta.
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At this stage, the decision was made to operate, to prevent aneurysmal complications (Fig. 1).
Status after complete debranching of the aortic arch. (A) Main body of the bifurcated graft onto the ascending aorta, (B) right limb to the right carotid and subclavian arteries, (C) left limb to the left carotid and subclavian arteries, (D) temporary side branch, and (E) innominate vein.
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In advance, a temporary side branch (9 mm) was sewn onto the main body (Fig. 2), to provide endoprosthesis access.
Three dimensional reconstruction of the computed tomography angiogram one month post-operatively showing an adequate position of the stent graft without endoleak and a patent debranched aorta.
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