Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
J Endovasc Ther. 2021 Aug;28(4):524-529. doi: 10.1177/15266028211007475. Epub 2021 Apr 15.
Laser-fenestrated thoracic endovascular aortic repair (LfTEVAR) in the aortic arch with covering of the left subclavian artery (LSA) orifice is challenging. To optimize fenestration, the so-called squid-capture technique has been introduced. We present here a modification to the technique that may help improve time-efficiency and safety.
: During the originally proposed squid-capture maneuver, the stent-graft is deployed in a preset snare wire loop, which is used to pull the stent graft toward the penetration device during in-situ fenestration. In preparation, the guidewire needs to be passed through the loop inside the aortic arch, which can be difficult and may predispose for embolic events. We propose here the creation of a "guidewire-through-snare-loop" configuration outside the body, which can then be reliably transferred into the aortic arch. The modified technique was successfully applied in a patient undergoing LfTEVAR for penetrating aortic ulcers.
The proposed modification may help facilitate the squid-capture technique for LfTEVAR while saving time and resources. Given that LfTEVAR is becoming more frequently used, it is important to ensure technical success and safety of the procedure.
覆盖左锁骨下动脉（LSA）开口的主动脉弓部腔内血管修复术（LfTEVAR）具有挑战性。为了优化开窗，引入了所谓的“鱿鱼捕获”技术。我们在此介绍了一种技术改良，可能有助于提高效率和安全性。
在最初提出的鱿鱼捕获操作中，支架移植物被部署在预设的圈套丝环中，该环用于在原位开窗时将支架移植物拉向穿透装置。为此，导丝需要穿过主动脉弓内的环，这可能很困难，并可能导致栓塞事件。我们建议在体外创建“导丝通过圈套环”结构，然后可靠地将其转移到主动脉弓内。改良技术成功应用于 1 例穿透性主动脉溃疡行 LfTEVAR 的患者。
所提出的改良方法可能有助于促进 LfTEVAR 的鱿鱼捕获技术，同时节省时间和资源。鉴于 LfTEVAR 的应用越来越频繁，确保该手术的技术成功和安全性非常重要。
