Customized Fenestrated Single-Branched Stent Graft for Aortic Arch Aneurysm Repair.

BACKGROUND

We report the first successful placement of a customized fenestrated stent graft for treatment of an aortic arch aneurysm in China.

CASE SUMMARY: A 59-year-old Chinese man underwent thoracic endovascular repair for type-B aortic dissection 14 years ago. Follow-up computed tomography angiography (CTA) revealed a new aortic arch aneurysm and type Ia endoleak involving the left common carotid artery and left subclavian artery, which could not be treated with single-branch stents. A manufactory-made, thoracic single-branch stent with 2 fenestrations was customized for the patient's aortic anatomy. The stent was implanted with 3 supra-arch branches reconstructed. The postoperative CTA showed that the 3 aortic arch branches remained patent, and both the aneurysm and type Ia endoleak were fully sealed.

DISCUSSION: Customized fenestration on single-branch stent grafts is a promising advancement in treating aortic arch aneurysms. This technique offers personalized solutions that preserve branch perfusion while minimizing surgical invasiveness.