Authors
Yutaro Hori, Tsuyoshi Shibata, Shingo Tsushima, Kenta Yoshikawa, Shun Hayasaka, Hirokazu Sugiura, Hajime Maeda, Tomohiro Nakajima, Junji Nakazawa, Ayaka Arihara, Kenichi Kato, Shigeki Komatsu, Masato Yonemori, Yutaka Iba
Published in
General thoracic and cardiovascular surgery cases. Volume 5. Issue 1. Sep 22, 2026. Epub Sep 22, 2026.
Abstract
Open surgical repair remains the gold standard for aortic arch aneurysms, and endovascular treatment options are limited in high-risk patients. We report successful treatment of a distal aortic arch aneurysm using physician-modified fenestrated/inner-branched endovascular aortic repair (PM-F/iBEVAR), suggesting its feasibility as an alternative strategy.
A 50-year-old man presented with a distal aortic arch aneurysm enlargement after stent graft migration following preemptive thoracic endovascular aortic repair. The patient had significant neurological sequelae with impaired activities of daily living and was considered unsuitable for conventional arch replacement after multidisciplinary discussion. PM-F/iBEVAR was performed, and an inner branch was sutured only to the left subclavian artery in this patient. Although a type II endoleak was detected on postoperative day 3, the type Ia endoleak had resolved, and patency of the arch branch vessels was well maintained. The patient was discharged without any complications. At 6 months, the aneurysm remained stable without enlargement.
This case report suggests that PM-F/iBEVAR may be a feasible option for patients at high risk for open surgical repair with anatomically challenging distal aortic arch aneurysms.
PMID:
42773497
Bibliographic data and abstract were imported from PubMed on 23 Sep 2026.
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