Wang Zhi-Wei, Qiao Zhen-Tao, Li Ming-Xing, Bai Hua-Long, Liu Yuan-Feng, Bai Tao
Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China.
World J Clin Cases. 2022 Feb 6;10(4):1401-1409. doi: 10.12998/wjcc.v10.i4.1401.
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.
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.
This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.
近肾腹主动脉瘤(JAAA)的血管腔内修复通常需要结合各种支架移植物改良技术以保持分支通畅。作为一种可行的技术,顺行原位激光开窗术仍需根据具体情况进一步改进。
本报告描述了一例通过顺行原位激光开窗术在维持肾动脉血流的情况下成功进行血管腔内修复的病例。激光开窗术是通过将可操纵鞘管置于肾动脉开口前方的支架移植物腔内来进行的。在裸支架区域未释放的情况下,可维持肾动脉灌注,并通过实时血管造影实现精确定位。
本研究表明,这种新型的顺行原位激光开窗技术对特定的JAAA患者具有可行性和短期安全性。