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Ann Thorac Surg 2004;78:e17-e18
© 2004 The Society of Thoracic Surgeons

How to do it

The "elephant trunk" technique made easier

Eugenio Neri, MDa*, Massimo Massetti, MDb, Guido Sani, MDc

a Department of Surgery, Siena University School of Medicine, Siena, Italy
b Service de Chirurgie Thoracique et Cardiovasculaire, Caen University, Caen, France
c Division of Cardiovascular Surgery, Florence University School of Medicine, Florence, Italy

Accepted for publication November 7, 2003.

* Address reprint requests to Dr Neri, Department of Surgery, Siena University School of Medicine, Policlinico "Le Scotte," Viale M. Bracci, 53100 Siena, Italy
e-mail: nerie{at}unisi.it

In patients with diffuse aneurysmal disease, the "elephant trunk" technique, which uses surplus intravascular graft length to facilitate subsequent operations on the downstream aorta, is an accepted method of treatment. Nevertheless, in the presence of large aneurysms without a definite neck beyond the left subclavian artery, there is an increased risk of rupture at the level of the distal anastomosis. My colleagues and I herein describe a modified elephant trunk technique performed with a new prosthesis, which was conceived to overcome the difficulties and the risks inherent in a large aneurysmal neck.




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