Invaginated Graft Insertion Anastomosis for a Type Ib Endoleak at the Supraceliac Aorta Following Thoracic Endovascular Aortic Repair

Open surgery for a type Ib endoleak after thoracic endovascular aortic repair is associated with some knacks and pitfalls, particularly in cases wherein the distal edge of a stent graft is located at just supraceliac aorta and the renovisceral segment and infrarenal aorta do not require surgical intervention. Here we describe the invaginated graft insertion technique to provide an easy and secure anastomosis in such clinical situations. This procedure may be feasible for anastomosis between a prosthetic vascular graft and a previously deployed stent graft when the location of the anastomosis is distant from the surface of the skin incision with a narrow and limited surgical view.