3.8 Article

Use of target vessel ballooning to facilitate endovascular treatment in the case of branched endovascular aneurysm repair with a retrograde approach

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DOI: 10.1016/j.jvscit.2023.101330

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Branched EVAR; Endovascular procedures; Retrograde approach; Thoracoabdominal aortic aneurysm

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This study reports a new technique for endovascular aneurysm repair, which involves a retrograde approach and the use of an angioplasty balloon for added stability. The technique is feasible in cases with ostial stenosis of the target vessel.
A case of a new technique for branched endovascular aneurysm repair with a retrograde approach and ostial stenosis of the target vessel is reported. An angioplasty balloon was placed within the target vessel and used to give added stability to catheter advancement to place the stiff guidewire needed for placement of a bridging stent graft. In brief, a standard guidewire was first placed inside the target vessel through the retrograde approach. Next, the balloon was placed from outside the stent graft, again through a contralateral retrograde approach. Then, the angioplasty balloon was inflated, and a support catheter was advanced to the balloon and then slowly deflated to allow the catheter to advance. Finally, the stiff guidewire was placed. Subsequently, the bridging stent was placed and deployed. This technique is feasible and can be used in selected cases to use a retrograde approach when ostial stenosis of the target vessel is present.

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