Abstract
When treating a thoracic arch aneurysm (TAA) with the need to preserve the left subclavian artery (LSA), there are occasions where the chimney technique is combined with a Zone 2 thoracic endovascular aortic repair (TEVAR). In an orthodox chimney technique, the graft is deployed towards the proximal end, which results in a shorter overlap with the main stent graft, hence leaving a risk of gutter leakage. We hereby report a case treated with the periscope endograft (PG) technique, which could compensate for this disadvantage by deploying the chimney graft towards the peripheral end. The case is a 76-year-old male, with a TAA right after the LSA. The aneurysm was saccular towards the left anterior chest wall with two blisters, and its maximum diameter was 65 mm. The patient requested a minimally invasive treatment, so zone 2 TEVAR performed with a PG technique was planned. The postoperative course was uneventful, and the postoperative CT showed no endoleak. Although the long term prognosis has not been documented, this method could be minimally invasive and useful, especially in case of emergency. There are only a few reports concerning the PG technique to maintain perfusion to the LSA, and reports concerning the PG technique using heparin-bonded covered stent (VIABAHN) could not be found.
