Video-assisted mini-thoracotomy for thoracic stent-graft implantation: A novel vascular access for endovascular repair

Purpose: To report a new access technique for endovascular treatment of penetrating ulcer of the proximal descending aorta. Technique: When traditional access routes are unavailable, a 10-mm Dacron graft can be sutured to the distal descending aorta using a video-assisted mini-thoracotomy. Prerequisites for use of this novel approach are a focal lesion of the proximal descending aorta and a minimally diseased distal descending aorta for safe graft insertion. Conclusions: This procedure facilitates endovascular repair and obviates the risks of open surgery, which are especially beneficial in patients with significant comorbidities.