Graft joint inflow strategy for visceral debranching in hybrid thoracoabdominal aortic aneurysm repair

In hybrid thoracoabdominal aortic aneurysm repair, inflow selection is a critical determinant of visceral perfusion.Conventional limb-based inflow may result in unfavorable hemodynamics, whereas direct trunk inflow can compromise the distal landing zone for endovascular repair.We describe a graft joint inflow strategy for visceral debranching that utilizes the junction between the trunk and limbs of a bifurcated graft.This configuration relocates the inflow closer to the abdominal aortic axis while preserving landing zone flexibility.The technique is presented as an alternative inflow strategy in selected hybrid procedures.