# A novel endovascular perfusion branch strategy to reduce the risk of spinal cord ischemia in complex thoracoabdominal aortic aneurysm repair

## TL;DR

A new surgical strategy was used to reduce spinal cord ischemia risk during aortic aneurysm repair in a patient with Turner syndrome.

## Contribution

A novel endovascular perfusion branch strategy was introduced for complex aortic aneurysm repair.

## Key findings

- The patient's aneurysm was successfully treated using a combination of debranching and endograft placement.
- Spinal cord ischemia risk was mitigated by deploying stents into the aortic true lumen.
- The perfusion branch was safely occluded after a successful test under local anesthesia.

## Abstract

We present the case of a 39-year-old woman with Turner syndrome and a 65-mm postdissection type 2 thoracoabdominal aortic aneurysm, with a coarctation and extremely narrow true lumen. The patient underwent thoracic and abdominal debranching followed by endograft placement from the ascending aorta to the infrarenal aorta through the false lumen. Self-expanding stents were deployed from the iliosplenic graft, through the dissected celiac artery, and into the aortic true lumen to reduce the risk of spinal cord ischemia. Four weeks later, after test occlusion of the perfusion branch under local anesthesia, the stent was occluded with a vascular plug.