Toronto PowerWire fenestration technique to access false lumen branches in fenestrated endovascular aneurysm repair for chronic type B dissection

Steffan Frosi Stella; Thomas F Lindsay; Kong T Tan

doi:10.1016/j.jvs.2018.06.200

Toronto PowerWire fenestration technique to access false lumen branches in fenestrated endovascular aneurysm repair for chronic type B dissection

J Vasc Surg. 2019 Jan;69(1):249-252. doi: 10.1016/j.jvs.2018.06.200. Epub 2018 Aug 31.

Authors

Steffan Frosi Stella¹, Thomas F Lindsay², Kong T Tan³

Affiliations

¹ Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: steffan.frosistella@uhn.ca.
² Division of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
³ Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.

PMID: 30177409
DOI: 10.1016/j.jvs.2018.06.200

Abstract

Chronic type B aortic dissection with aneurysmal degeneration requiring intervention presents significant therapeutic challenges. Thoracic endovascular aortic repair with a fenestrated endograft is a feasible option, but false lumen branches without an adjacent re-entry or perforation in the septum can pose a significant challenge. We present two cases of fenestrated endovascular aneurysm repair for chronic type B aortic dissection in which a renal artery from the false lumen was cannulated by creating a "neofenestration" through the dissection flap using a radiofrequency PowerWire (Baylis Medical Inc, Montreal, Quebec, Canada) technique (Toronto PowerWire fenestration technique).

Keywords: Chronic dissection; F-EVAR; Fenestration; Radiofrequency wire; TEVAR.

Publication types

Case Reports

MeSH terms

Aged
Aortic Aneurysm, Thoracic / diagnostic imaging
Aortic Aneurysm, Thoracic / surgery*
Aortic Dissection / diagnostic imaging
Aortic Dissection / surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / instrumentation
Blood Vessel Prosthesis Implantation / methods*
Chronic Disease
Computed Tomography Angiography
Endovascular Procedures / instrumentation
Endovascular Procedures / methods*
Female
Humans
Male
Radiography, Interventional
Stents
Treatment Outcome
Vascular Access Devices