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In situ Laser Fenestration of Visceral Endografts (InLoVE): Midterm Outcomes from a Multicentre Study
Gísli G Jónsson1, Alexander H Zielinski2, Marton Berczeli3
1Division of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Summary
In situ laser fenestration (ISLF) is a promising endovascular technique for complex aortic emergencies. This multicenter study shows high technical success and good midterm outcomes for ISLF in renovisceral aortic pathologies.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Disease Management
Background:
- Complex abdominal aortic diseases present significant treatment challenges.
- In situ laser fenestration (ISLF) offers a method to restore flow through covered aortic branches.
- Midterm outcomes of ISLF in renovisceral pathology require further investigation.
Purpose of the Study:
- To evaluate the midterm outcomes of in situ laser fenestration (ISLF).
- To assess ISLF in patients with renovisceral aortic pathology.
- To analyze multicenter data on ISLF procedures.
Main Methods:
- Retrospective analysis of pooled data from three aortic centers (2018-2023).
- Inclusion of consecutive in situ laser fenestration cases for visceral aortic stent grafts.
- Definition of technical success and target vessel instability criteria.
Main Results:
- Sixty-five ISLFs were performed in 34 patients; 79% were acute, 35% were ruptures.
- Technical success rate was 94% (61/65).
- Median follow-up was 16 months; cumulative survival at 2 years was 72%. Freedom from target vessel instability was 89% at 6 months. Primary assisted patency was 100%.
Conclusions:
- In situ laser fenestration is a viable endovascular option for emergency complex aortic pathologies.
- ISLF demonstrates promising midterm results in renovisceral aortic disease.
- The technique facilitates endovascular repair in challenging anatomies.
