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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 4/2019

01-04-2019 | Technical Note

Catheter-Directed Fenestration for Branch Vessel Reconnection in Aortic Dissection Using a Novel Diamond-Tipped Chronic Total Occlusion Drilling Device: A Technical Report

Authors: Rim Ghali, Julian Maingard, Hong Kuan Kok, George Matalanis, Siven Seevanayagam, Hamed Asadi, Duncan Mark Brooks

Published in: CardioVascular and Interventional Radiology | Issue 4/2019

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Abstract

Purpose

Aortic dissection is a complex condition with high morbidity and mortality. Endovascular treatments including percutaneous fenestration can be used to manage branch vessel ischaemia or risk of aortic rupture. A variety of techniques for aortic fenestration have been described. We describe the novel use of the TruePath Chronic Total Occlusion (CTO) device for aortic intimal fenestration to achieve side branch reconnection.

Materials and Methods

We present three cases of aortic dissection presenting with symptoms of aortic side branch occlusion and end organ malperfusion, treated with aortic fenestration using the TruePath CTO device via trans-brachial and trans-femoral approaches.

Results

Technical success was achieved in all three cases. No complications were encountered. Flow was restored in compromised visceral branches. Branches remained patent on follow-up CT angiography over a minimum 2.5-year follow-up period.

Conclusion

Percutaneous aortic fenestration techniques enable a minimally invasive approach to treat visceral branch malperfusion associated with aortic dissection. The TruePath CTO device improves the control of the fenestration procedure with the potential to improve efficacy and safety.
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Metadata
Title
Catheter-Directed Fenestration for Branch Vessel Reconnection in Aortic Dissection Using a Novel Diamond-Tipped Chronic Total Occlusion Drilling Device: A Technical Report
Authors
Rim Ghali
Julian Maingard
Hong Kuan Kok
George Matalanis
Siven Seevanayagam
Hamed Asadi
Duncan Mark Brooks
Publication date
01-04-2019
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 4/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-018-2124-8

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