Transcatheter endothermal septotomy in complex endovascular repair of dissected aortic aneurysms

Extensive aortic aneurysms with chronic dissection present a challenge in complex endovascular aortic repair due to limited luminal working room, suboptimal landing zones, and target vessels which may originate from the false lumen. Adjunctive endothermal septotomy is a technique to modify the aortic anatomy to a state more amenable to minimally invasive repair. This technique uses radiofrequency energy to transect the aortic septum, creating a common lumen within which to conduct the aortic repair. In this narrative review, the technique for endothermal septotomy is described and the supporting literature is summarized. While rigorous study of the technique remains limited at present, early experience has demonstrated feasibility and safety.