Complex multi stage thoracoabdominal aneurysm correction. Branched endograft with forced femoral access and flap perforation

acute type B aortic dissection with thoracic aortic aneurysm. no proximal sealing zone for TEVAR landing and dilated ascending aorta.

-Car-car-sub by pass
-Ascending aortic replacement, ascending to innominate by pass and TEVAR

@ control CTA fast aneurysm enlargement

4 inner branches (two antegrade and two retrograde) custom made endograft.
access to RRA through hole performed in the lamella
forced femoral access (no arch vessel available) with steerable sheat


    Dr. Theodosios Bisdas
    April 15, 2019

    nice case Gioele and congrats. Just a short question: Which sheath was that (Oscor or Fustar)?

    Dr Gioele Simonte
    April 18, 2019

    thanks for the comment, actually the steerable sheats used were two different Oscor .
    We had to use two devices since once deployed the SMA bridging stent the radius curve of the sheat we used (7 fr) turned out to be too sharp for the advancement of the CT bridging stent as we were not able to push it over the sheat curve. we had than to pick up a 10 fr with a wider curve easily resolving the problem.
    no experience with the Fustar in my facility

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