A Novel Technique to Arrange Retrograde Visceral Bypass Grafts used in Hybrid Therapy for Thoracoabdominal Aortic Aneurysms

AbstractHybrid therapy administered for thoracoabdominal aortic aneurysm involves stent grafts and surgical reconstruction. This therapy entails retrograde visceral artery bypass before stent-graft implantation, establishing an inflow from either the distal abdominal aorta or the iliac arteries. Kinking is of great concern since it may cause acute occlusion, especially in grafts to the celiac axis and superior mesenteric artery because these vessels are directed caudally toward the right. Here, we describe a novel technique to achieve good exposure of the visceral vessels and appropriate graft position