Challenging Catheterization of a Branch in an Endovascular Thoracoabdominal Aneurysm Repair

Purpose: To describe a novel technique of cannulating a side branch during endovascular repair of a thoracoabdominal aneurysm (TAAA). Technique: The approach evolved during endovascular repair of a type III TAAA in which a custom-designed graft with 3 caudally directed branches was being deployed in...

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Bibliographic Details
Published inJournal of endovascular therapy Vol. 17; no. 3; pp. 391 - 394
Main Authors D'Elia, Piervito, O'Brien, Noel, Sobocinski, Jonathan, Lerussi, Gilles, Perot, Celine, Azzaoui, Richard, Haulon, Stéphan
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.06.2010
Allen Press Inc
Subjects
Aged
Aneurysms
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Blood Vessel Prosthesis Implantation - methods
Catheterization - instrumentation
Catheters
Equipment Design
Humans
Ischemia
Male
Medical imaging
Prosthesis Design
Renal Artery - diagnostic imaging
Stents
Tomography, X-Ray Computed
Treatment Outcome
Veins & arteries
Wire
endovascular repair
branched endografts
thoracoabdominal aneurysm
cannulation
side branch
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Summary:Purpose: To describe a novel technique of cannulating a side branch during endovascular repair of a thoracoabdominal aneurysm (TAAA). Technique: The approach evolved during endovascular repair of a type III TAAA in which a custom-designed graft with 3 caudally directed branches was being deployed in a patient who had a prior surgical repair for a type IV TAAA. Two of the branches were successfully cannulated and stented, but repeated efforts to cannulate the left renal branch and artery via the standard brachial approach were unsuccessful. A catheter positioned between the graft and the aneurysm sac was used to gain retrograde access to this branch. From a left brachial access this guidewire was snared and used to allow bridging stent deployment between the branch and the renal artery, thus completing the procedure. Conclusion: This report describes a novel technique to deal with challenging side branch cannulation that may be encountered during branched stent-graft deployment.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:1526-6028
1545-1550
DOI:10.1583/09-2933.1