Presenter: P. M. Kasprzak

Affiliation: University Hospital Regensburg, Germany

Abstract

This article evaluates stent-graft strategies for atypical CMD branches (e.g., IMA, intercostals, accessory renals) in thoracoabdominal aortic aneurysm (TAAA) repair. Techniques using Fluency, BeGraft+, and VBX stents achieved 95% success in branch preservation and reduced endoleaks, validated by postoperative imaging.

Introduction

Atypical CMD branches occur in 1-5% of TAAA cases, posing challenges for conventional endovascular repair. This study highlights tailored stent selection and implantation to address anatomical variations.

Case Study

A TAAA patient (aneurysm >60mm) with intercostal and accessory renal branches:

Stent Selection: 6mm downward and 6-8mm upward branches (18mm length).

Technique: BeGraft+® and VBX stents with post-dilation.

Preventive Embolization: IMA >3mm embolized to prevent type II endoleak.

Follow-up CTA confirmed aneurysm exclusion and branch patency.

Conclusions

1.Customized stent design optimizes branch revascularization.

2.Prophylactic embolization mitigates endoleak risks.

3.Multimodal imaging ensures procedural accuracy.