Vascular | 2021
The effect of in situ laser fenestration for total endovascular arch repair in redo aortic dissection.
Abstract
OBJECTIVE\nTreatment of aortic arch pathologies in redo cases is technically challenging. In this study, we assessed early and mid-term outcomes of total endovascular arch repair combined with a new method of in situ laser fenestration.\n\n\nMETHODS\nBetween January 2018 and March 2019, five patients with a history of cardiovascular surgery underwent in situ laser fenestration procedures using the squid capture technique for aortic arch pathologies with dissection. All patients were followed up regularly and imaging examinations were performed. The technical success, procedural complications, as well as the early and mid-term mortality and morbidity rates were evaluated.\n\n\nRESULTS\nAll patients survived the operation and fenestration was technically successful in all of the patients. There was no in-hospital mortality. No patients developed major complications, such as peri-operative strokes, transient ischemic attacks, or spinal cord ischemia. The 11-22\xa0months follow-up (mean, 17\xa0months) was completed by all patients. No endoleaks were discovered; false lumen thromboses and subsequent positive remodeling of the aorta were demonstrated and all in situ laser-fenestrated arteries were patent.\n\n\nCONCLUSIONS\nIn situ laser fenestration combined with squid capture technique was shown to may be an effective and safe option for reconstruction of aortic arch during thoracic endovascular aortic repair. In situ laser fenestration combined with squid capture technology was shown to be an effective treatment option for patients with prior history of cardiovascular surgery and who are at high risk for redo open operations.