Use of steerable catheters for endovascular procedures: Report of a CASE and literature review

Abstract

We report a case of a celiac trunk stenting using a steerable guiding catheter, to fix a residual endoleak following fenestrated endovascular repair (FEVAR) of a thoracoabdominal aortic aneurysm (TAAA). A systematic search of the literature about the use of steerable catheters was also performed on Pubmed according to the PRISMA Guidelines, including all papers in which the device was used for in vivo endovascular procedures.In our case report, the patient had undergone a failed attempt of cannulation due to the presence of a severely angulated and stenosed ostium of the vessel. A steerable catheter was then used to fix the residual endoleak. The search of the Literature retrieved 544 papers. Of them, 13 met the inclusion criteria and were therefore assessed. The use of steerable sheaths and catheters was reported as effective and safe for the cannulation of 157 target vessels in 131 endovascular procedures, with a success rate of 95.5% and no complications. The use of a steerable guiding catheter in our experience was safe and effective for the selective cannulation of a severely stenosed and angulated celiac trunk, to correct a residual endoleak after FEVAR for TAAA. Steerable catheters could be useful tools for the selective cannulation of target vessels with a challenging ostium. K E Y W O R D Scatheter design, endovascular intervention, surgery, endovascular

A review on the use of steerable sheaths in complex endovascular aortic repair

“…Mazzaccaro et al 10 reported a failure to cannulate the celiac trunk of a patient undergoing fenestrated‐EVAR with challenging anatomy who subsequently had a successful second‐stage attempt using a steerable sheath.…”

Aneurysms and dissections - What is new in the literature of 2019/2020 - a European Society of Vascular Medicine annual review

“…Torsello et al tested the use of BeGraft and BeGraft + in an in vitro study and reported superiority of the BeGraft + in terms of pullout, shear stress and resilience [185]. Literature review by Mazzaccaro et al demonstrated that the use of steerable sheaths and catheters was reported as effective and safe for the cannulation of 157 target vessels in 131 endovascular procedures, with a success rate of 95.5% and no complications [186]. It may be helpful in cases with failing attempts of cannulation e.g.…”