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

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Presentation transcript:

Toronto PowerWire fenestration technique to access false lumen branches in fenestrated endovascular aneurysm repair for chronic type B dissection Steffan Frosi Stella, MD, ScD, Thomas F. Lindsay, MD, MSc, Kong T. Tan, MD Journal of Vascular Surgery Volume 69, Issue 1, Pages 249-252 (January 2019) DOI: 10.1016/j.jvs.2018.06.200 Copyright © 2018 Society for Vascular Surgery Terms and Conditions

Fig 1 Illustrative diagram of the Toronto PowerWire fenestration technique (TPFT). A, Radiofrequency wire activation adjacent to the planned fenestration. B, Dissection flap crossed and false lumen accessed. C, Fenestration enlargement. D, Covered stent bridging the renal artery. Journal of Vascular Surgery 2019 69, 249-252DOI: (10.1016/j.jvs.2018.06.200) Copyright © 2018 Society for Vascular Surgery Terms and Conditions

Fig 2 Case 1, contrast-enhanced abdominal computed tomography (CT; axial view and coronal straight aorta reformat) demonstrating dissection flap, origin of the renal arteries, and flap natural fenestration. A, Right renal artery arising from the false lumen. B, Right renal artery arising from the false lumen below the level of the natural flap fenestration. Journal of Vascular Surgery 2019 69, 249-252DOI: (10.1016/j.jvs.2018.06.200) Copyright © 2018 Society for Vascular Surgery Terms and Conditions

Fig 3 Case 1, fluoroscopy imaging of the endovascular fenestrated graft procedure. A, Radiofrequency wire crossing through the false lumen after power activation with continuous wave for 1 second. B, Right renal artery cannulated and stented, with good flow and no signs of endoleak. Journal of Vascular Surgery 2019 69, 249-252DOI: (10.1016/j.jvs.2018.06.200) Copyright © 2018 Society for Vascular Surgery Terms and Conditions

Fig 4 Case 2, fluoroscopy imaging of the endovascular fenestrated graft procedure. A, The 8.5F vascular sheath positioned at the planned fenestration. B, Radiofrequency wire crossing through the chronic flap into the false lumen after power activation with continuous wave for 1 second. C, Fenestration enlargement with a 4-mm balloon. D, Left renal artery cannulated and stented. Completion angiogram with good flow and no signs of endoleak. Journal of Vascular Surgery 2019 69, 249-252DOI: (10.1016/j.jvs.2018.06.200) Copyright © 2018 Society for Vascular Surgery Terms and Conditions