Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1401
Peer-review started: September 1, 2021
First decision: November 22, 2021
Revised: December 6, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: February 6, 2022
Processing time: 144 Days and 11.7 Hours
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.
Core Tip: This report describes the feasibility and short-term safety of a novel antegrade in situ laser fenestration technique. During the operation, 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. The technique is uncomplicated and has potential as an alternative approach when dealing with a hostile proximal aortic neck during endovascular aortic repair.