Endovascular repair of type A dissection using thoracic stent graft with innominate artery flaring to correct for length mismatch

Type A aortic dissection is the most common aortic catastrophe posing challenges for endovascular repair owing to the fragile aortic wall, proximity to the aortic valve, coronaries, and supra-aortic trunks. While open surgical repair remains the gold standard, endovascular repair is considered in se...

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Main Authors: Aidin Baghbani-Oskouei, MD, Lucas Ruiter Kanamori, MD, Safa Savadi, MD, Steven Maximus, MD, Thanila A. Macedo, MD, Anthony Estrera, MD, Salman A. Arain, MD, Gustavo S. Oderich, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468428725000097
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Summary:Type A aortic dissection is the most common aortic catastrophe posing challenges for endovascular repair owing to the fragile aortic wall, proximity to the aortic valve, coronaries, and supra-aortic trunks. While open surgical repair remains the gold standard, endovascular repair is considered in select high-risk patients who meet anatomical criteria, including more than 10 mm length between sinotubular junction to primary tear, aortic diameter of less than 40 mm, and suitable length between sinotubular junction and innominate artery. This illustrated video and case presentation address a modified technique using stent graft flaring of the innominate artery to adjust for length mismatch in the ascending aorta.
ISSN:2468-4287