Use of Fenestrated Stent-Grafts for Preservation of Spinal Artery Flow During Endovascular Repair of Thoracoabdominal Aortic Disease

Abstract

We illustrate the safety and feasibility of the application of fenestrated stent-grafts for the preservation of spinal artery flow during endovascular repair of thoracoabdominal aortic aneurysms (TAAA) in 2 patients deemed high-risk for spinal cord ischemia (SCI). In one case, an unstented fenestration was used in a 78-year-old male treated for distal stent-graft induced new entry tear. In the other case, a fenestration with a bridging stent-graft was used to revascularize a spinal artery in a 66-year-old female with Marfan disease and island patch aneurysm following open TAAA reconstruction. Both procedures were successful without any postoperative neurologic complication. The unstented fenestration led to a type III endoleak that required the relining of the aortic stent-graft 2 years later. The stented spinal fenestration was patent at a 5-year imaging follow-up.

Early Experience With a Novel Dissection-Specific Stent-Graft to Prevent Distal Stent-Graft-Induced New Entry Tears After Thoracic Endovascular Repair of Chronic Type B Aortic Dissections

“…However, TEVAR with standard thoracic platforms in the setting of CTBAD carries a significant risk of dSINE, 6 which in turn may lead to aneurysm expansion, and warrant re-intervention. [7][8][9][10] Furthermore, dSINE have been lately recognized as a potential complication also following deployment of FET devices in patients undergoing proximal repair for type A dissection 11 , 12 (as noted in 2 patients from the present series).…”