PMC8242995_01
Computed tomography angiography reconstruction showing thoracic aneurysm.
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Computed tomography (CT) angiography confirmed the 7.2 cm fusiform aneurysm of the distal aortic arch, with an ectatic ascending aortic segment measuring up to 3.7 cm in diameter and a descending thoracic aneurysm measuring 4.2 cm (Fig. 1).
Pre-operative plan of custom made device.
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(A) Angiogram demonstrating aneurysm and origins of innominate artery (IA) and left common carotid artery (LCCA) retrograde puncture access. (B) Left subclavian artery (LSA) cannulation and occlusion. (C) Snaring of custom made device (CMD) preload wire into the LCCA. (D) LCCA BeGraft deployment and flaring. (E) Final placement of device.
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The left VA and distal SCA could be seen to be perfused via collateral flow (Fig. 3).
Computed tomography volume reconstruction of surveillance scan performed one month after repair.
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Follow up CT a month later showed that the stent graft, LCCA fenestration and IA were patent, and that the proximal LSA had been occluded as planned with collateral perfusion of the left VA and LSA distal to the vascular plug (Fig. 4).