Radiopaque Ruler-Guided Frozen Elephant Trunk Technique

Area of Science:

• Cardiovascular Surgery
• Medical Imaging
• Aortic Aneurysm Treatment

Background:

• The frozen elephant trunk (FET) technique is crucial for treating extensive thoracic aortic aneurysms, combining open and endovascular repair.
• Accurate positioning of the FET graft in the descending thoracic aorta is challenging but vital for successful outcomes.
• Improper FET placement can lead to complications, including spinal cord injury.

Purpose of the Study:

• To present a novel radiopaque ruler-guided technique for precise FET graft placement.
• To enhance the safety and efficacy of FET procedures for thoracic aortic aneurysms.
• To reduce the risk of spinal cord ischemia associated with FET implantation.

Main Methods:

• Preoperative computed tomography (CT) scans were used to create a surgical roadmap correlating the descending thoracic aorta with vertebral levels.
• A radiopaque ruler was employed during surgery, positioned beneath the patient's back.
• Fluoroscopy was utilized to guide the FET graft placement using the roadmap and radiopaque ruler for accurate targeting.

Main Results:

• The radiopaque ruler-guided technique allowed for accurate intraoperative confirmation of FET graft positioning.
• The method effectively prevented overly deep implantation of the FET graft.
• This technique demonstrated potential in mitigating the risk of spinal cord injury.

Conclusions:

• The radiopaque ruler-guided FET technique offers a reliable method for precise graft placement in thoracic aortic aneurysm repair.
• This approach enhances surgical safety by providing clear intraoperative guidance and reducing the risk of neurological complications.
• The technique is a valuable adjunct for surgeons performing FET procedures, improving patient outcomes.