Aortic arch banding procedure for proximal type I endoleak after thoracic endovascular aneurysm repair with the chimney technique Genta Chikazawa, MD,

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Aortic arch banding procedure for proximal type I endoleak after thoracic endovascular aneurysm repair with the chimney technique Genta Chikazawa, MD, PhD, Arudo Hiraoka, MD, Koichi Inoue, MD, Kentaro Tamura, MD, PhD, Taichi Sakaguchi, MD, PhD, Hidenori Yoshitaka, MD, PhD Journal of Vascular Surgery Cases and Innovative Techniques Volume 3, Issue 4, Pages 228-231 (December 2017) DOI: 10.1016/j.jvscit.2017.09.002 Copyright © 2017 The Author(s) Terms and Conditions

Fig 1 A and B, Computed tomography (CT) demonstrating an aortic arch aneurysm measuring a maximum diameter of 80 mm with extravasation of the contrast agent into the left thoracic cavity. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 228-231DOI: (10.1016/j.jvscit.2017.09.002) Copyright © 2017 The Author(s) Terms and Conditions

Fig 2 A and B, Computed tomography (CT) on the second day after the initial procedure revealing a rapid re-enlargement of the aneurysmal body from 80 to 94 mm in diameter caused by persistent type I endoleak. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 228-231DOI: (10.1016/j.jvscit.2017.09.002) Copyright © 2017 The Author(s) Terms and Conditions

Fig 3 Doubly encircled umbilical tape tightened at the level of complete disappearance of gutter endoleaks on aortography and sutured on the aortic adventitia. Ao, Aorta; BCA, brachiocephalic artery; IV, innominate vein. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 228-231DOI: (10.1016/j.jvscit.2017.09.002) Copyright © 2017 The Author(s) Terms and Conditions

Fig 4 A, Significant gutter type I endoleak (EL) identified on aortography before the banding procedure. B, Complete disappearance of endoleak demonstrated on aortography after the banding procedure. C, Computed tomography (CT) 2 days after the second procedure showing no endoleaks along with significant shrinkage of the aneurysmal sac from 94 to 88 mm. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 228-231DOI: (10.1016/j.jvscit.2017.09.002) Copyright © 2017 The Author(s) Terms and Conditions