Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration

Endovascular aortic aneurysm repair (EVAR) offers a minimally invasive treatment approach for abdominal aortic aneurysms (AAAs). Iliac limb misdeployment outside of the gate is a rare complication that traditionally requires open conversion. We describe two cases of limb misdeployment salvaged with...

Full description

Saved in:
Bibliographic Details
Main Authors: Mira T. Tanenbaum, MD, Andrea E. Klein, MD, Jacqueline L. Babb, MD, Mirza S. Baig, MD, Melissa L. Kirkwood, MD, Carlos H. Timaran, MD
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S246842872500156X
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849320994998583296
author Mira T. Tanenbaum, MD
Andrea E. Klein, MD
Jacqueline L. Babb, MD
Mirza S. Baig, MD
Melissa L. Kirkwood, MD
Carlos H. Timaran, MD
author_facet Mira T. Tanenbaum, MD
Andrea E. Klein, MD
Jacqueline L. Babb, MD
Mirza S. Baig, MD
Melissa L. Kirkwood, MD
Carlos H. Timaran, MD
author_sort Mira T. Tanenbaum, MD
collection DOAJ
description Endovascular aortic aneurysm repair (EVAR) offers a minimally invasive treatment approach for abdominal aortic aneurysms (AAAs). Iliac limb misdeployment outside of the gate is a rare complication that traditionally requires open conversion. We describe two cases of limb misdeployment salvaged with in situ laser fenestration (ISLF). An ISLF was created through the misplaced iliac limb into the aneurysm sac, allowing for subsequent gate cannulation. A new limb was then deployed from the gate through the fenestration into the iliac artery. These cases demonstrate that ISLF through a misdeployed EVAR limb is a novel bail-out endovascular technique that circumvents open surgery and restores the aortoiliac anatomic continuity of the repair.
format Article
id doaj-art-5487d7d5d4ae4aa08ebdf4a13502a0c4
institution Kabale University
issn 2468-4287
language English
publishDate 2025-10-01
publisher Elsevier
record_format Article
series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-5487d7d5d4ae4aa08ebdf4a13502a0c42025-08-20T03:49:54ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-10-0111510187410.1016/j.jvscit.2025.101874Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestrationMira T. Tanenbaum, MD0Andrea E. Klein, MD1Jacqueline L. Babb, MD2Mirza S. Baig, MD3Melissa L. Kirkwood, MD4Carlos H. Timaran, MD5Department of Surgery, George Washington University Hospital, Washington, DCDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TXOrlando Health Heart and Vascular Institute, Orlando, FLDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TXDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TXDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Correspondence: Carlos H. Timaran, MD, Department of Surgery, University of Texas Southwestern Medical Center, 5959 Harry Hines Blvd, POB 1, Ste 620, Dallas, TX 75390-9157Endovascular aortic aneurysm repair (EVAR) offers a minimally invasive treatment approach for abdominal aortic aneurysms (AAAs). Iliac limb misdeployment outside of the gate is a rare complication that traditionally requires open conversion. We describe two cases of limb misdeployment salvaged with in situ laser fenestration (ISLF). An ISLF was created through the misplaced iliac limb into the aneurysm sac, allowing for subsequent gate cannulation. A new limb was then deployed from the gate through the fenestration into the iliac artery. These cases demonstrate that ISLF through a misdeployed EVAR limb is a novel bail-out endovascular technique that circumvents open surgery and restores the aortoiliac anatomic continuity of the repair.http://www.sciencedirect.com/science/article/pii/S246842872500156XAbdominal aortaEVARIliac arteryLaser fenestration
spellingShingle Mira T. Tanenbaum, MD
Andrea E. Klein, MD
Jacqueline L. Babb, MD
Mirza S. Baig, MD
Melissa L. Kirkwood, MD
Carlos H. Timaran, MD
Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
Journal of Vascular Surgery Cases and Innovative Techniques
Abdominal aorta
EVAR
Iliac artery
Laser fenestration
title Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
title_full Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
title_fullStr Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
title_full_unstemmed Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
title_short Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
title_sort endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration
topic Abdominal aorta
EVAR
Iliac artery
Laser fenestration
url http://www.sciencedirect.com/science/article/pii/S246842872500156X
work_keys_str_mv AT mirattanenbaummd endovascularaorticrepairendograftlimbmisdeploymentsalvagedwithlaserfenestration
AT andreaekleinmd endovascularaorticrepairendograftlimbmisdeploymentsalvagedwithlaserfenestration
AT jacquelinelbabbmd endovascularaorticrepairendograftlimbmisdeploymentsalvagedwithlaserfenestration
AT mirzasbaigmd endovascularaorticrepairendograftlimbmisdeploymentsalvagedwithlaserfenestration
AT melissalkirkwoodmd endovascularaorticrepairendograftlimbmisdeploymentsalvagedwithlaserfenestration
AT carloshtimaranmd endovascularaorticrepairendograftlimbmisdeploymentsalvagedwithlaserfenestration