Key result
TEVAR with in situ laser fenestration proves feasible for zone 1 ruptured TAA requiring LIMA preservation.
Why the study?
Thoracic endovascular aortic repair for ruptured thoracic aortic aneurysms involving the proximal arch is timely and challenging, making arch revascularization via novel methods such as in situ laser fenestration important to evaluate.
Case Report (n=1)
In situ laser fenestration of the left subclavian and left common carotid artery during TEVAR is a feasible approach for emergent repair of ruptured proximal arch thoracic aortic aneurysms.
Offers bailout option for complex ruptured TAA repair; leaves open safety, durability, and generalizability.
Most thoracic aortic aneurysms (TAAs) are asymptomatic and often diagnosed at the time of rupture. TAAs involving the proximal arch require adequate coverage with thoracic endovascular aortic repair, which is timely and challenging in emergent ruptures. In situ laser fenestration is a novel method of arch revascularization. We present an 85-year-old man with zone 2 aortic pathology, a ruptured TAA, and a history of a left internal mammary to left anterior descending artery bypass. This case report demonstrates feasibility of a zone 1 repair for a ruptured TAA involving left carotid and left subclavian fenestration in a patient requiring unique attention to left internal mammary artery patency.
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Rhudy et al. (2024) conducted a case report in Ruptured thoracic aortic aneurysm (n=1). Thoracic endovascular aortic repair with in situ laser fenestration was evaluated on Feasibility of zone 1 repair. Thoracic endovascular aortic repair with in situ laser fenestration was feasible for a zone 1 repair of a ruptured thoracic aortic aneurysm in a patient requiring LIMA patency preservation.
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