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Related Experiment Video

Updated: May 1, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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In Situ Laser Fenestration for Subclavian Preservation During Aortic Dissection Repair.

Charlotte Burch1, S Ayesha Farooq2, Mark Levy2

  • 1School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA, vcu.edu.

Case Reports in Vascular Medicine
|April 30, 2026
PubMed
Summary

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Laser fenestration is a new technique for thoracic endovascular aortic repair (TEVAR). This method successfully maintained blood flow to the arch vessels in a patient undergoing descending thoracic aorta repair.

Area of Science:

  • Vascular Surgery
  • Endovascular Techniques
  • Aortic Aneurysm Repair

Background:

  • Thoracic endovascular aortic repair (TEVAR) is a minimally invasive treatment for thoracic aortic pathologies.
  • Maintaining perfusion to arch vessels during TEVAR can be challenging.
  • Aneurysmal degeneration of the descending thoracic aorta requires complex repair strategies.

Purpose of the Study:

  • To describe the application of in situ laser fenestration during TEVAR.
  • To demonstrate the technique's efficacy in preserving subclavian arterial flow.
  • To present a case of TEVAR with laser fenestration for descending thoracic aortic aneurysm.

Main Methods:

  • A 40-year-old female patient with a history of ascending aortic repair underwent debranching of the left carotid and innominate arteries.
Keywords:
TEVARaortic dissectionlaser fenestration

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  • Thoracic endovascular aortic repair (TEVAR) was performed using a novel in situ laser fenestration technique.
  • The laser fenestration created an opening in the endograft to maintain arch vessel perfusion.

    • Main Results:

    • Successful creation of an opening in the endograft using laser fenestration.
    • Preservation of blood flow to the arch vessels, including the subclavian artery.
    • The procedure addressed aneurysmal degeneration of the descending thoracic aorta.

    Conclusions:

    • In situ laser fenestration is a viable technique for maintaining arch vessel perfusion during TEVAR.
    • This approach offers a solution for complex TEVAR cases requiring preservation of supra-aortic branches.
    • Laser fenestration represents a significant advancement in endovascular aortic repair techniques.