Staged proximal deployment of the Zenith TX2 thoracic stent-graft: a novel technique to improve conformance to the aortic arch

PURPOSE: To present a modification of the Zenith TX2 thoracic stent-graft that allows staged proximal deployment to improve apposition to the aortic wall.

TECHNIQUE: Three standard Zenith TX2 thoracic stent-grafts and 3 modified versions were deployed in a glass model of the aortic arch. Deployment sequences were analyzed. In a patient with a 6-cm thoracic aortic aneurysm after a type B dissection, the modified Zenith TX2 thoracic stent-graft was deployed successfully and without complications; the proximal part of the stent-graft protruded less into the arch, significantly improving wall apposition.

CONCLUSION: Staged proximal deployment with a modified Zenith TX2 thoracic stent-graft can improve orientation and wall apposition of the first Z stent. A better proximal apposition may prevent early and late stent-graft complications.