In vitro fenestrated endovascular aortic repair deployment and cannulation using an electromagnetically steerable...

Precise guidewire navigation is critical in branched and fenestrated endovascular aortic repair, where target vessel cannulation often requires multiple devices. This study assessed the feasibility of electromagnetic guidewire navigation in a four-fenestration fenestrated endovascular aortic repair model. A custom-made endograft was deployed in a three-dimensional silicone thoracoabdominal aneurysm model. Renal and visceral arteries were cannulated using a magnetically steerable guidewire and electromagnetic navigation via femoral access. All four target vessels were successfully cannulated using the magnetic guidewire alone; three were stented without adjunctive devices. Magnetically guided navigation enabled accurate cannulation without steerable sheaths or support catheters, potentially reducing procedural complexity.