Staged open ascending aortic replacement and endovascular total arch repair using a three-inner-branch physician-modified endograft for chronic postdissection aneurysms.
4 affiliations
- 1Department of Vascular Surgery, MedStar Washington Hospital Center-Georgetown University Hospital, Washington, DC.
- 2Department of Surgery, Georgetown University School of Medicine, Washington, DC.
- 3The Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
- 4Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, DC.
Abstract
This report describes a single-admission, two-stage hybrid approach for chronic postdissection aneurysmal degeneration of the ascending aorta and aortic arch. Stage 1 consists of open ascending aortic replacement without deep hypothermic circulatory arrest. Stage 2 uses a three-inner-branch physician-modified endograft with novel features for total arch repair, relying on the surgical graft from stage 1 as the proximal landing zone. To minimize cardiac pulsatility-induced motion, atriocaval occlusion was used, alongside a repurposed thoracic branch endoprosthesis side branch for secure innominate artery sealing. This less invasive strategy simplifies arch reconstruction and broadens treatment options for high-risk patients with postdissection multisegment aneurysms.
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BibTeX
@article{yoon2026staged,
title = {{Staged open ascending aortic replacement and endovascular total arch repair using a three-inner-branch physician-modified endograft for chronic postdissection aneurysms.}},
author = {William J Yoon and Alexander P Nissen},
journal = {Journal of vascular surgery cases and innovative techniques},
year = {2026},
month = sep,
doi = {10.1016/j.jvscit.2026.102527},
url = {https://europepmc.org/article/MED/42921229},
note = {CC BY},
}
RIS
TY - JOUR
TI - Staged open ascending aortic replacement and endovascular total arch repair using a three-inner-branch physician-modified endograft for chronic postdissection aneurysms.
AU - William J Yoon
AU - Alexander P Nissen
PY - 2026
DA - 2026/09/20
JO - Journal of vascular surgery cases and innovative techniques
DO - 10.1016/j.jvscit.2026.102527
UR - https://europepmc.org/article/MED/42921229
AB - This report describes a single-admission, two-stage hybrid approach for chronic postdissection aneurysmal degeneration of the ascending aorta and aortic arch. Stage 1 consists of open ascending aortic replacement without deep hypothermic circulatory arrest. Stage 2 uses a three-inner-branch physician-modified endograft with novel features for total arch repair, relying on the surgical graft from stage 1 as the proximal landing zone. To minimize cardiac pulsatility-induced motion, atriocaval occlusion was used, alongside a repurposed thoracic branch endoprosthesis side branch for secure innominate artery sealing. This less invasive strategy simplifies arch reconstruction and broadens treatment options for high-risk patients with postdissection multisegment aneurysms.
SN - 2468-4287
ER -