1:45 PM, Abstract No. 112 - Percutaneous aortic fenestration for patients with symptomatic type B aortic dissection

Abstract

PurposeTo evaluate outcomes for percutaneous fenestration in patients with symptomatic type B aortic dissection.Materials and MethodsFive percutaneous aortic fenestration procedures performed between 2011 and 2014 were retrospectively reviewed. All patients were symptomatic (lower extremity claudication (n=1), mesenteric hypoperfusion (n=3), renal insufficiency (n=1)) at the time of procedure with CT angiograms demonstrating differential perfusion between true and false lumen. After review of abdominal and pelvic CTA, procedures were performed using a common femoral artery approach under fluoroscopic guidance. Punctures were made using a catheter with a flexible trocar stylet followed by 6-10 mm angioplasty. Primary outcomes were relief of pressure gradient between true and false lumen, and relief from signs and symptoms of mesenteric, renal or peripheral ischemia.ResultsTechnical success was 100%. All patients had improved perfusion and symptom resolution after fenestration procedure, and there were no intra- or periprocedural complications. Follow up CTA demonstrated equalization of flow in all cases.ConclusionPercutaneous aortic fenestration is rarely performed but very effective in alleviating ischemic symptoms attributable to symptomatic type B dissection. PurposeTo evaluate outcomes for percutaneous fenestration in patients with symptomatic type B aortic dissection. To evaluate outcomes for percutaneous fenestration in patients with symptomatic type B aortic dissection. Materials and MethodsFive percutaneous aortic fenestration procedures performed between 2011 and 2014 were retrospectively reviewed. All patients were symptomatic (lower extremity claudication (n=1), mesenteric hypoperfusion (n=3), renal insufficiency (n=1)) at the time of procedure with CT angiograms demonstrating differential perfusion between true and false lumen. After review of abdominal and pelvic CTA, procedures were performed using a common femoral artery approach under fluoroscopic guidance. Punctures were made using a catheter with a flexible trocar stylet followed by 6-10 mm angioplasty. Primary outcomes were relief of pressure gradient between true and false lumen, and relief from signs and symptoms of mesenteric, renal or peripheral ischemia. Five percutaneous aortic fenestration procedures performed between 2011 and 2014 were retrospectively reviewed. All patients were symptomatic (lower extremity claudication (n=1), mesenteric hypoperfusion (n=3), renal insufficiency (n=1)) at the time of procedure with CT angiograms demonstrating differential perfusion between true and false lumen. After review of abdominal and pelvic CTA, procedures were performed using a common femoral artery approach under fluoroscopic guidance. Punctures were made using a catheter with a flexible trocar stylet followed by 6-10 mm angioplasty. Primary outcomes were relief of pressure gradient between true and false lumen, and relief from signs and symptoms of mesenteric, renal or peripheral ischemia. ResultsTechnical success was 100%. All patients had improved perfusion and symptom resolution after fenestration procedure, and there were no intra- or periprocedural complications. Follow up CTA demonstrated equalization of flow in all cases. Technical success was 100%. All patients had improved perfusion and symptom resolution after fenestration procedure, and there were no intra- or periprocedural complications. Follow up CTA demonstrated equalization of flow in all cases. ConclusionPercutaneous aortic fenestration is rarely performed but very effective in alleviating ischemic symptoms attributable to symptomatic type B dissection. Percutaneous aortic fenestration is rarely performed but very effective in alleviating ischemic symptoms attributable to symptomatic type B dissection.