An externalized transseptal guidewire technique to facilitate guidewire stabilization and stent-graft passage in the aortic arch
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An externalized transseptal guidewire technique to facilitate guidewire stabilization and stent-graft passage in the aortic arch. / Kölbel, Tilo; Rostock, Thomas; Larena-Avellaneda, Axel; Treede, Hendrik; Franzen, Olaf; Debus, Eike Sebastian.
in: J ENDOVASC THER, Jahrgang 17, Nr. 6, 12.2010, S. 744-749.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - An externalized transseptal guidewire technique to facilitate guidewire stabilization and stent-graft passage in the aortic arch
AU - Kölbel, Tilo
AU - Rostock, Thomas
AU - Larena-Avellaneda, Axel
AU - Treede, Hendrik
AU - Franzen, Olaf
AU - Debus, Eike Sebastian
PY - 2010/12
Y1 - 2010/12
N2 - PURPOSE: To describe a technique to facilitate passage and stable deployment of thoracic stent-grafts in patients with multiple tortuous aortic segments that may hamper endograft delivery or precise placement because of an unstable position in the aortic arch.TECHNIQUE: The technique of a transseptal through-and-through guidewire is demonstrated in a patient with a ruptured thoracic aneurysm with severe tortuosity of the aorta and a right-sided, severely angulated aortic arch. The transseptal through-and-through guidewire stabilization technique allowed successful passage and deployment of a thoracic stent-graft after debranching of the right common carotid and subclavian arteries. The ruptured thoracic aneurysm was excluded, while the proximal graft edge lined up with the origin of the aberrant left innominate artery.CONCLUSION: An externalized transseptal guidewire can facilitate endograft passage in tortuous aortic anatomies and optimize control in most severely angulated aortic arches. It may obviate the use of proximal bare stents because the proximal stent-graft is actively conformed to the inner curve of the aortic arch by the stabilizing wire. Transseptal access to the ascending aorta has the potential to become an important tool for endovascular treatment, especially for catheterization of branches and fenestrations in aortic arch stent-grafts.
AB - PURPOSE: To describe a technique to facilitate passage and stable deployment of thoracic stent-grafts in patients with multiple tortuous aortic segments that may hamper endograft delivery or precise placement because of an unstable position in the aortic arch.TECHNIQUE: The technique of a transseptal through-and-through guidewire is demonstrated in a patient with a ruptured thoracic aneurysm with severe tortuosity of the aorta and a right-sided, severely angulated aortic arch. The transseptal through-and-through guidewire stabilization technique allowed successful passage and deployment of a thoracic stent-graft after debranching of the right common carotid and subclavian arteries. The ruptured thoracic aneurysm was excluded, while the proximal graft edge lined up with the origin of the aberrant left innominate artery.CONCLUSION: An externalized transseptal guidewire can facilitate endograft passage in tortuous aortic anatomies and optimize control in most severely angulated aortic arches. It may obviate the use of proximal bare stents because the proximal stent-graft is actively conformed to the inner curve of the aortic arch by the stabilizing wire. Transseptal access to the ascending aorta has the potential to become an important tool for endovascular treatment, especially for catheterization of branches and fenestrations in aortic arch stent-grafts.
KW - Angiography, Digital Subtraction
KW - Aortic Aneurysm, Thoracic/diagnostic imaging
KW - Aortic Rupture/diagnostic imaging
KW - Aortography/methods
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/instrumentation
KW - Cardiac Catheterization/instrumentation
KW - Endovascular Procedures/instrumentation
KW - Equipment Design
KW - Humans
KW - Male
KW - Middle Aged
KW - Prosthesis Design
KW - Radiography, Interventional
KW - Stents
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
U2 - 10.1583/10-3189.1
DO - 10.1583/10-3189.1
M3 - SCORING: Journal article
C2 - 21142483
VL - 17
SP - 744
EP - 749
JO - J ENDOVASC THER
JF - J ENDOVASC THER
SN - 1526-6028
IS - 6
ER -