Transcatheter electrosurgical septotomy technique for chronic postdissection aortic aneurysms

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Chronic aortic dissection frequently leads to aneurysmal degeneration from false lumen expansion.
• Endovascular aortic repair (EVAR) techniques are increasingly used for chronic postdissection aneurysms.
• True lumen compression and false lumen vessel origins pose significant technical challenges in EVAR.

Purpose of the Study:

• To summarize the indications for transcatheter electrosurgical septotomy in chronic postdissection aneurysms.
• To outline the technical pitfalls associated with this novel septotomy technique.
• To evaluate its application in patients undergoing endovascular repair.

Main Methods:

• Transcatheter electrosurgical septotomy, adapted from cardiology procedures, is utilized selectively.
• Technique involves creating landing zones, disrupting compressed true lumens, or connecting lumens.
• Application is demonstrated in patients with chronic dissection undergoing EVAR.

Main Results:

• The technique addresses challenges like inadequate stent graft expansion and difficult catheter manipulation.
• It facilitates target vessel catheterization and repair in complex aortic anatomies.
• Specific applications include creating proximal/distal landing zones and managing separate vessel origins.

Conclusions:

• Transcatheter electrosurgical septotomy is a valuable adjunct for complex endovascular aortic aneurysm repair.
• It effectively manages true lumen compression and facilitates access in challenging chronic dissections.
• Understanding indications and technical pitfalls is crucial for successful application.