Key result
In situ laser fenestration for delayed LSA revascularization post-TEVAR yields 80% technical success without endoleakage.
Why the study?
There were no reports on the application of in situ laser fenestration for delayed revascularization of the left subclavian artery previously sealed in TEVAR.
Is in situ laser fenestration effective and safe for delayed left subclavian artery revascularization following TEVAR for type B aortic dissection?
Case Report (n=5)
Is in situ laser fenestration effective and safe for delayed left subclavian artery revascularization following TEVAR for type B aortic dissection?
In situ laser fenestration appears to be a feasible and safe minimally invasive option for delayed LSA revascularization after TEVAR.
May support feasibility for delayed LSA revascularization after TEVAR; leaves open need for larger prospective validation before practice change.
In situ laser fenestration (ISLF) is currently used to reconstruct the aortic major branches during thoracic endovascular aortic repair (TEVAR). To our knowledge, there have been no reports on the application of ISLF for delayed revascularization of the LSA previously sealed in TEVAR. This report describes 5 patients who underwent ISLF for delayed LSA revascularization, with a technical success rate of 80%. No endoleakage occurred, and stents remained patent during more than 6-month follow-up. ISLF is an effective, safe and minimally invasive method for delayed revascularization of the LSA following TEVAR for type B aortic dissection (TBAD) when patients are selected appropriately.
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Wang et al. (2021) conducted a case report in Type B aortic dissection requiring delayed left subclavian artery revascularization following TEVAR (n=5). In situ laser fenestration (ISLF) was evaluated on Technical success rate. In situ laser fenestration for delayed left subclavian artery revascularization following TEVAR achieved an 80% technical success rate in 5 patients, with no endoleakage at >6 months follow-up.
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