A modified squid capture technique for improved laser position during in situ fenestration

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• In situ laser fenestration is crucial for thoracic endovascular aortic repair (TEVAR).
• Complex aortic arch anatomy presents challenges for orthogonal laser alignment.
• Existing techniques may involve significant intravascular manipulation, increasing risks.

Purpose of the Study:

• To present a modified "squid capture" technique for improved laser alignment during TEVAR.
• To demonstrate a simple, reproducible method for challenging aortic anatomies.
• To reduce risks associated with intravascular manipulation in TEVAR.

Main Methods:

• A temporary, removable wire loop is used to stabilize the sheath against the endograft.
• This facilitates perpendicular laser positioning, enhancing fenestration accuracy.
• The technique was applied in a case with residual dissection and aneurysmal degeneration.

Main Results:

• The modified technique successfully achieved perpendicular laser positioning.
• Minimized intravascular manipulation was observed.
• The approach proved effective in a patient with complex aortic arch anatomy.

Conclusions:

• The modified "squid capture" technique offers a safe and effective solution for laser fenestration in TEVAR.
• It is particularly beneficial for patients with complex aortic arch anatomy.
• This method reduces the risk of embolic events, stroke, and arterial injury.