Thoraflex Graft in an inverted position for post-dissection thoraco-abdominal aneurysm

Abstract We present the off-label use of a Thoraflex TM Hybrid Plexus Prosthesis (Vascutek, Scotland, UK) to treat a post-dissection type IV thoraco-abdominal aortic aneurysm (TAA) in a high-risk patient previously treated with a thoracic stent-graft for a chronic type B aortic dissection. The Thoraflex graft was used in a "reversed frozen elephant trunk" fashion: the stent graft portion deployed in the previously placed thoracic stent, and the branched portion used to revascularize visceral arteries and lower limbs. Our off-label use of the Thoraflex graft was technically successful. Further experiences are required to confirm the safety of this technique in high-risk patients.