Enrico Gallitto1, Mauro Gargiulo2, Gianluca Faggioli2, Alessia Sonetto2, Chiara Mascoli2, Rodolfo Pini2, Mohamhed Abualhin2, Andrea Stella2. 1. Vascular Surgery, Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy. Electronic address: enrico.gallitto@gmail.com. 2. Vascular Surgery, Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
Abstract
PURPOSE: To describe an endovascular technique to close a renal artery fenestration during fenestrated endograft implant for a pararenal abdominal aortic aneurysm (p-AAA) without interfering with other visceral vessels. REPORT: A 76-year-old man with p-AAA underwent repair by a 4 fenestrations custom-made endograft. At the intraprocedural angiography, the right renal artery was occluded. To avoid a high-flow endoleak from fenestration, we performed the following technique: a 9F-steerable sheath was used to advance a 7F sheath through the fenestration into aneurism. A balloon-expandable covered stent was deployed across the fenestration and then occluded by 2 vascular plugs. At the completion angiography, there was no endoleak from the right renal fenestration, and at 6-month period, p-AAA remained completely excluded. CONCLUSIONS: The present technique can be a safe and effective therapeutic option to propose in cases of impossible target visceral vessels cannulation during p-AAA repair using a custom-made device to avoid the aneurysmal sac perfusion.
PURPOSE: To describe an endovascular technique to close a renal artery fenestration during fenestrated endograft implant for a pararenal abdominal aortic aneurysm (p-AAA) without interfering with other visceral vessels. REPORT: A 76-year-old man with p-AAA underwent repair by a 4 fenestrations custom-made endograft. At the intraprocedural angiography, the right renal artery was occluded. To avoid a high-flow endoleak from fenestration, we performed the following technique: a 9F-steerable sheath was used to advance a 7F sheath through the fenestration into aneurism. A balloon-expandable covered stent was deployed across the fenestration and then occluded by 2 vascular plugs. At the completion angiography, there was no endoleak from the right renal fenestration, and at 6-month period, p-AAA remained completely excluded. CONCLUSIONS: The present technique can be a safe and effective therapeutic option to propose in cases of impossible target visceral vessels cannulation during p-AAA repair using a custom-made device to avoid the aneurysmal sac perfusion.