Wang ZW, Qiao ZT, Li MX, Bai HL, Liu YF, Bai T. Antegrade in situ laser fenestration of aortic stent graft during endovascular aortic repair: A case report. World J Clin Cases 2022; 10(4): 1401-1409 [PMID: 35211576 DOI: 10.12998/wjcc.v10.i4.1401]
Corresponding Author of This Article
Zhen-Tao Qiao, MD, Attending Doctor, Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, No. 1 Longhu Central Ring Road, Zhengzhou 450003, Henan Province, China. qzt212@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2022; 10(4): 1401-1409 Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1401
Antegrade in situ laser fenestration of aortic stent graft during endovascular aortic repair: A case report
Zhi-Wei Wang, Zhen-Tao Qiao, Ming-Xing Li, Hua-Long Bai, Yuan-Feng Liu, Tao Bai
Zhi-Wei Wang, Zhen-Tao Qiao, Ming-Xing Li, Hua-Long Bai, Yuan-Feng Liu, Tao Bai, Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China
Author contributions: Wang ZW and Qiao ZT contributed equally to this work; Wang ZW and Qiao ZT designed the research study; Wang ZW, Qiao ZT, Li MX and Bai HL performed the operation; Liu YF and Bai T collected the clinical data; Qiao ZT analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-Tao Qiao, MD, Attending Doctor, Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, No. 1 Longhu Central Ring Road, Zhengzhou 450003, Henan Province, China. qzt212@163.com
Received: September 1, 2021 Peer-review started: September 1, 2021 First decision: November 22, 2021 Revised: December 6, 2021 Accepted: December 23, 2021 Article in press: December 23, 2021 Published online: February 6, 2022 Processing time: 144 Days and 11.7 Hours
Abstract
BACKGROUND
The endovascular repair of juxtarenal abdominal aortic aneurysms (JAAA) usually requires combination treatment with various stent graft modifications to preserve side branch patency. As a feasible technique, according to the situation, antegrade in situ laser fenestration still needs to be improved.
CASE SUMMARY
This report describes a case that was successfully treated with endovascular repair facilitated by antegrade in situ laser fenestration while maintaining renal arterial flow. Laser fenestration was performed using a steerable sheath positioned in the stent graft lumen in front of the renal artery ostium. With the bare stent region unreleased, renal artery perfusion could be maintained and accurate positioning could be achieved by angiography in real time.
CONCLUSION
This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.
Core Tip: This report describes the feasibility and short-term safety of a novel antegrade in situ laser fenestration technique. During the operation, laser fenestration was performed using a steerable sheath positioned in the stent graft lumen in front of the renal artery ostium. With the bare stent region unreleased, renal artery perfusion could be maintained and accurate positioning could be achieved by angiography in real time. The technique is uncomplicated and has potential as an alternative approach when dealing with a hostile proximal aortic neck during endovascular aortic repair.
