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In situ fenestration in the aortic arch

Authors
Journal
Journal of Vascular Surgery
0741-5214
Publisher
Elsevier
Publication Date
Volume
52
Issue
2
Identifiers
DOI: 10.1016/j.jvs.2009.07.088

Abstract

In situ fenestration of aortic stent grafts has the potential to allow for continued perfusion of supra-aortic trunks, without the need for extra-anatomic bypass, and without the need for custom-made devices. Angulation of the target vessel relative to the arch is an obstacle to success with this technique. In this report, we describe a case of successful in situ fenestration of the left subclavian artery (LSA) in a patient with an aortic arch aneurysm, treated with an endovascular stent graft. We outline a novel technique using through and through wire access and a pre-curved semi-rigid sheath, which allows successful access to the lumen of the aortic stent graft, despite an acute angle at the take-off of the LSA.

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