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generation GORE TAG stent graft had a long wire along the
length of the stent graft, which limited its pliability. In the
second generation, the spine wire was removed and the expanded polytetraﬂuoroethylene (ePTFE) material was thicker.
In the third-generation GORE C-TAG stent graft, ePTFE is
only partially attached to the stent, which allows the C-TAG
stent graft to have increased conformability. The GORE TAG
deployment strings were originally made to release the stent graft
from the middle portion of the graft outwards towards the ends
of the graft simultaneously to theoretically avoid the wind sock
eﬀect, but in this case it was found that by individually pulling
the deployment strings, there was better control and accuracy
in deployment of the graft without concern for the stent graft
coming oﬀ the deployment catheter. After the ﬁrst deployment
string is pulled, the stent graft is still secured adequately to the
delivery device to allow for minor positional adjustments by
either pushing up or down on the device before deploying the
remaining portion of the stent graft. The stent graft can be bent/
curved along with the stiﬀ wire outside the body prior to being
placed into deployment position to improve proper landing of
the graft. The GORE C-TAG stent graft can also be selectively
deployed in a reverse manner.
Future generations of thoracic stent grafts should allow for
more precise control over deployment. For example, the GORE
AAA conformable stent graft, currently in clinical trials, oﬀers
the ability to adjust the proximal portion of the stent graft prior
to deployment, similar to the method we found by selective
deployment in our Parachute technique. Until then, this novel
technique oﬀers the possibility of more precise GORE TAG
stent graft placement.
Figure 4. Postdeployment CT angiography.
1.

the aortic wall, the graft eﬀectively landed across the leak. Oﬀlabel modiﬁcation of separating deployment strings and thus
selectively deploying the distal end of the GORE C-TAG stent
graft allowed successful management of the aortic angulation.
The position of the graft could then be adjusted before deploying the proximal end of the graft.
The GORE TAG stent graft has undergone several engineering modiﬁcations since its introduction in 2001. The ﬁrst-

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Baylor University Medical Center Proceedings

Volume 30, Number 3

Table of Contents for the Digital Edition of Baylor University Medical Center Proceedings July 2017