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Fenestrated TEVAR Using a Guidewire Fixator for Anchoring in Aortic Arch Target Vessels
Tilo Kölbel1, Linus Bosaeus2, Nikolaos Tsilimparis1
11 German Aortic Center, Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
Purpose:
To report a new facilitated method for securing target vessel access during single fenestrated and branched thoracic endovascular repair using a guidewire fixator.
Technique:
The Liungman Guidewire Fixator (LGF) includes a 0.035-inch guidewire that is fitted with a stopper close to the distal end and a self-expanding anchoring element that is freely movable over the guidewire to the point of the stopper. The technique of using a LGF for anchoring in a target vessel is described in a 75-year-old woman with a 53-mm saccular arch aneurysm. She was treated with a fenestrated Zenith stent-graft that had a catheter-preloaded fenestration for the left subclavian artery (LSA) and a scallop for the left common carotid artery. To avoid through-and-through wire and brachial access, the LGF was used to secure the guidewire in the LSA during stent-graft deployment.
Conclusion:
The use of an LGF for anchoring in the target LSA during fenestrated arch endografting was feasible and safe.
