Percutaneous fenestration using a transseptal needle and balloon angioplasty can successfully treat ischemic complications caused by false lumen expansion after surgical repair of Type 1 aortic dissection.
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Should not yet change practice for post-dissection ischemia; leaves open the role of percutaneous fenestration pending prospective data.
After successful replacement of the ascending aorta and the aortic arch for a Type 1 aortic dissection, a persistent intimal tear resulted in expansion of the false lumen and in lower extremity and renal ischemia. This was successfully treated with percutaneous fenestration of the suprarenal abdominal aorta by means of a transseptal needle and balloon angioplasty. There were no complications, and benefits continued to result from the procedure at 4 months' follow-up.
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Khoury et al. (1998) studied this question.
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