The Use of a Commercially Available Endovascular Filter Catheter (Capturex®) for Thoracic Endovascular Aortic Repair (TEVAR) in a Patient with a Coral Reef Aorta

Rupert Horst Portugaller; Jakob Steiner; Florian Schmid; Igor Knez; Martin Asslaber; Hannes A Deutschmann

doi:10.1007/s00270-022-03147-6

The Use of a Commercially Available Endovascular Filter Catheter (Capturex^®) for Thoracic Endovascular Aortic Repair (TEVAR) in a Patient with a Coral Reef Aorta

Cardiovasc Intervent Radiol. 2022 Jun;45(6):879-883. doi: 10.1007/s00270-022-03147-6. Epub 2022 Apr 26.

Authors

Rupert Horst Portugaller¹, Jakob Steiner², Florian Schmid³, Igor Knez⁴, Martin Asslaber⁵, Hannes A Deutschmann³

Affiliations

¹ Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz (MUG), Auenbruggerplatz 9A, A-8036, Graz, Austria. rupert.portugaller@medunigraz.at.
² Division of General Radiological Diagnostics, Department of Radiology, Medical University of Graz (MUG), Auenbruggerplatz 9A, A-8036, Graz, Austria.
³ Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz (MUG), Auenbruggerplatz 9A, A-8036, Graz, Austria.
⁴ Division of Cardiac Surgery, Department of Surgery, Medical University of Graz (MUG), Auenbruggerplatz 29/3, A-8036, Graz, Austria.
⁵ Department of Diagnostic and Scientific Pathology, Medical University of Graz (MUG), Neue Stiftingtalstraße 6, A-8036, Graz, Austria.

Abstract

Due to the risk of mobilizing plaque fragments, transfemoral TEVAR is a potentially dangerous procedure in patients with a coral reef aorta. We describe a practical method for transfemoral TEVAR in a patient with a degenerative thoracic aneurysm and a coral reef aorta. After placing a filter catheter in the abdominal aorta via a contralateral percutaneous femoral access, a working channel through the distal thoracic aorta was created with a balloon-expandable stent graft in the coral reef segment. Thereafter, transfemoral TEVAR could be performed successfully, without any complications. The additional use of a percutaneously placed filter catheter potentially allows reduction of peripheral embolism and hence may prevent patients from more invasive treatment.

Keywords: Coral reef aorta; Filter catheter; TEVAR; Thoracic aortic aneurysm.

MeSH terms

Aorta
Aorta, Thoracic / diagnostic imaging
Aorta, Thoracic / surgery
Aortic Aneurysm, Thoracic* / complications
Aortic Aneurysm, Thoracic* / diagnostic imaging
Aortic Aneurysm, Thoracic* / surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects
Catheters
Coral Reefs
Endovascular Procedures* / methods
Humans
Retrospective Studies
Stents
Treatment Outcome