Endovascular arch repair using inner branch stent-graft with trans-apical access.

Abstract Endovascular repair of aortic arch aneurysms has been considered in higher risk patients who are not ideally suited for open surgical or hybrid repair. A limitation of these devices is the eight to twelve-week delay for manufacturing, which does not allow treatment of symptomatic or rapidly expanding aneurysms. This report illustrates urgent endovascular repair of aortic arch aneurysm using a physician modified endograft (PMEG) with two inner branches. Trans-apical access allowed better support and precision during device deployment, which was needed given the short proximal landing zone.