Total Aortic Arch Endoprosthetic Repair using the ?Outside? and ?In-Situ? Fenestration Techniques: First Results in Russia

Abstract

Akhmedov U49052*, Sharafutdinov M49064, Yakubov R49065, Sadykov R49066, Khairutdinov A49067 and Tarasov Yu49068

Over the past 20 years, there has been a clear shift towards endovascular repair of the thoracic aorta in its various pathologies. However, complete endovascular repair of the aortic arch remains technically sophisticated. Currently, there are several methods of endovascular arch treatment: A hybrid approach, total endovascular debranching using parallel grafts (like a chimney or snorkeling) and fenestration (factory- made, hand-made (physician modified graft (PMG)) in-situ or outside (on-a-table)). The first results of the application of the aortic arch repair technology are promising, especially the complete replacement of the aortic arch be means of non-standard fenestrated or branched stent grafts. Use of fenestrated or branched grafts factory FTEVAR and Chimney is an attractive method for treating of aortic arch diseases but they have a higher cost and longer waiting time.