In situ laser fenestration during emergent thoracic endovascular aortic repair is an effective method for left subclavian artery revascularization

Redlinger, Richard E.; Ahanchi, Sadaf S.; Panneton, Jean M.

doi:10.1016/j.jvs.2013.04.045

Cited by 158 publications

(145 citation statements)

References 19 publications

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“…Several options have been described that allow patency of the left SCA to be maintained, including preoperative left SCA revascularization by elective debranching before TEVAR, the hybrid repair by combining endovascular and open repair, the chimney technique by deploying a left SCA stent parallel to the thoracic endograft, prefabricated branched endograft deployment, or surgeon modified endografts [18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

Mhamdi

Nakhli

Chelly

et al. 2015

Egyptian Journal of Anaesthesia

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Subclavian steal syndrome (SCSS) has been known since 1960 in the medical literature. Its principal cause is atherosclerosis responsible of occlusion of the subclavian artery (SCA). It is the pathological process in which blood flows in reverse direction from the vertebral artery (VA) to the SCA. Usually asymptomatic, but a variety of symptoms may develop involving the vertebro-basilar and/or the carotid territories and may be precipitated by exercise of the upper extremity. In some circumstances it can be iatrogenic complicating the course of a thoracic endovascular aortic repair (TEVAR) when the left SCA is covered by the endoprosthesis, which is a necessity many times giving the frequent proximity of the acute thoracic pathologies to the origin of this vessel. We present a case of severe headache occurring after a TEVAR with intentional coverage of the origin of the left SCA. This headache was the only symptom from which the patient complained, and which disappeared immediately after carotid-SCA bypass. Other devastating complications can happen, which gave as a concern about the management of SCA when decision to practice a TEVAR is taken.ª 2015 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.

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Section: Discussionmentioning

confidence: 99%

Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

Mhamdi

Nakhli

Chelly

et al. 2015

Egyptian Journal of Anaesthesia

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“…In addition, a simple puncture with hostile geometry potentially not only creates an inadequate hole on the main graft but may also injure the native aorta, access arteries or surrounding organs, which can lead to fatal complications. To obtain secure and high-quality fenestrations, the delivery sheath and needle should be ideally angled at 90°to the graft material [7,9]. The squid-capture technique aids in attaining a perpendicular angle between the needle and the graft during the fenestration process and thus helps in the creation of high-quality fenestrations without any complications due to puncture error (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…This technique can also be applied with laser-based fenestration [9,10], which also needs accurate positioning of the laser catheter to ensure precise puncturing of the endograft. This technique can even be adopted for the left subclavian and carotid arteries to fit various anatomical conditions.…”

Section: Discussionmentioning

confidence: 99%

“Squid-Capture” Modified In Situ Stent–Graft Fenestration Technique for Aortic Arch Aneurysm Repair

Hongo

Miyamoto

Shuto

et al. 2014

Cardiovasc Intervent Radiol

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An 83-year-old female was found to have an fusiform aneurysm in the aortic arch. She was deemed to be a high surgical risk; therefore, endovascular stent-graft placement followed by revascularization of the brachiocephalic trunk using in situ stent-graft fenestration was considered. However, the safe application of fenestration was deemed difficult due to the tortuosity of the brachiocephalic artery. The patient was successfully treated with the aid of the ''squid-capture'' technique, which consists of deployment of the stent-graft in a snare wire loop that was advanced from the brachiocephalic artery and fenestration of the stent-graft with the support of the loop. A follow-up exam revealed complete sealing of the aneurysm without any complications. The squid-capture technique allows for the safe and secure puncture of the graft.

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“…2,3 Reports of procedures that maintain the patency of the LSA include debranching before elective TEVAR, 4 the chimney technique of deployment of a LSA stent parallel to the thoracic stent graft, 5 and retrograde laser fenestration. 6 The purpose of the following study was to review our experience with homemade proximal scalloped stent grafts for TEVAR of zone 2 acute aortic syndrome.…”

Section: Perspectivementioning

confidence: 99%

Homemade proximal scalloped stent graft for thoracic endovascular aortic repair of zone 2 acute aortic syndrome

Canaud

Gandet

Khantalin

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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The use of the homemade proximal scalloped stent graft is both feasible and effective for left subclavian artery revascularization during thoracic endovascular aortic repair involving a spectrum of acute thoracic aortic pathology. This approach provides a rapid, reproducible method of scalloping the endograft. Durability concerns will need to be assessed in additional studies with long-term follow-up.

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In situ laser fenestration during emergent thoracic endovascular aortic repair is an effective method for left subclavian artery revascularization

Cited by 158 publications

References 19 publications

Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

“Squid-Capture” Modified In Situ Stent–Graft Fenestration Technique for Aortic Arch Aneurysm Repair

Homemade proximal scalloped stent graft for thoracic endovascular aortic repair of zone 2 acute aortic syndrome

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