Application of a Reversed Off-the-Shelf Iliac Branched Device Stent in Revascularization of the Renal Artery Originating from the False Lumen.

PURPOSE: Fenestrated/branched endovascular aneurysm repair is a feasible and effective treatment option for patients with post-dissection thoracoabdominal/abdominal aneurysm. However, this technique is cumbersome when the target vessel originates from the false lumen. We herein report our primary experiences in utilizing a reversed off-the-shelf iliac branched device (IBD) stent to reconstruct the renal artery originating from the false lumen. CASE REPORT: This technique was performed in three patients (all men; 49-, 46- and 45-years-old) in our center. After deployment of the main aortic endograft, the distal reentry in the common iliac artery was dilated by a balloon. The off-the-shelf IBD was then reversely deployed to allow for deployment of the bridging stent graft. Finally, the IBD and the bridging stents were assembled and the IBD was connected to the main graft. No migration of the IBDs occurred, and all target vessels remained patent during follow-up. CONCLUSION: Utilization of a reversed off-the-shelf IBD for the renal artery originating from the false lumen is a feasible option, especially for patients with specific anatomical characteristics of post-dissection aortic aneurysms.