Concomitant left subclavian artery (LSA) fenestration is recommended in thoracic endovascular
aortic repair (TEVAR) for revascularization when the LSA is covered. However, the
sheath alignment lacks an accurate and efficient positioning method due to the angulation
of LSA anatomy. We developed a novel method for sheath aligning characterized by the
guiding catheter's front junction (J.) with the graft stent and descending (D.) aorta
proceeding. It forms a curved traction system that drags the puncture needle to the
center of LSA orifice. A 93.8% endoleak-free rate was observed during the 9.0 (4.0–17.5)
months follow-up in 137 patients. No reintervention or mortality was observed. Our
sheath aligning method can be safely performed in LSA fenestration, which simplifies
the surgical procedure and may help to avoid iatrogenic complications.
Keywords
aorta/aortic - stents - vascular science (biochemistry pharmacology pathology etc.)
- endovascular procedures/stents except PCI
