Erasing narrow paravisceral true lumen with endoseptostomy to favor adequate expansion of branched endograft during postdissection thoracoabdomimal aortic aneurysm endovascular repair

Michele Piazza; Michele Antonello

doi:10.1016/j.jvscit.2024.101461

Erasing narrow paravisceral true lumen with endoseptostomy to favor adequate expansion of branched endograft during postdissection thoracoabdomimal aortic aneurysm endovascular repair

J Vasc Surg Cases Innov Tech. 2024 Feb 28;10(3):101461. doi: 10.1016/j.jvscit.2024.101461. eCollection 2024 Jun.

Authors

Michele Piazza¹, Michele Antonello¹

Affiliation

¹ Vascular and Endovascular Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University, Padova, Italy.

Abstract

Narrow paravisceral aortic true lumen in postdissection thoracoabdominal aneurysm, represents a challenging situation when branched endovascular aneurysm repair is required; it may be responsible for intraprocedural technical difficulties, such as inadequate main endograft deployment, difficult vessels catheterization, or long-term branch instability related to compression. We describe the case of a 56-year-old man with post-type B thoracoabdominal aortic aneurysm and a severely narrow true lumen (10 mm) at the paravisceral segment. Endovascular aortic septostomy was performed first, to erase the narrow paravisceral aortic true lumen, and subsequently allow branched endograft adequate expansion and regular vessels catheterization.