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In the conventional way of thoraco-abdominal aortic replacement, the intercostal arteries are reimplanted directly to the main aortic graft or by the interposition of branch grafts. To overcome the disadvantages of these techniques, we adopted a different technique using a parallel side graft. The good patency rate of reimplanted intercostal arteries achieved by this technique and its potential technical advantages can contribute to the improvement of the surgical outcome. [ABSTRACT FROM AUTHOR]

Reconstruction of the visceral and intercostal arteries is the most challenging part in the open repair of thoraco-abdominal aortic aneurysm. For efficient and expeditious reconstruction of these branching vessels, a technique of using a pre-handsewn 8-branch aortic graft (octopod technique) has been adopted. The octopod graft was manually constructed using commercially available two 4-branch aortic grafts that were spatially oriented based on the preoperative computed tomographic images and connected each other prior to surgery. This approach was adopted in 12 open repairs of extent II thoraco-abdominal aortic aneurysms from 2015 to 2017, including 8 Marfan patients. Median pump and procedural times were 173 (102-207) min and 437 (343-489) min, respectively. There was no operative mortality or spinal cord injury. The octopod technique for open thoraco-abdominal aortic aneurysm repair showed excellent early results with high procedural efficiency. [ABSTRACT FROM AUTHOR]