In-Situ Laser Fenestration of a PTFE Thoracic Aortic Stent Graft for Delayed Left Subclavian Artery Revascularization Following Frozen Elephant Trunk Repair of Type an Aortic Dissection

Abstract

Left subclavian artery revascularization during endovascular repair of aortic dissection is often accomplished by left carotid-subclavian artery bypass or transposition. In-situ fenestration of thoracic stent grafts provides an alternative method of revascularization without manipulation of the left carotid artery. We describe a novel technique of delayed in-situ laser fenestration, combined with catheter-directed thrombectomy to revascularize a thrombosed left subclavian artery in a patient with frozen elephant trunk repair of type A aortic dissection.