Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration

Authors

Mira T. Tanenbaum, Department of Surgery, George Washington University Hospital, Washington, DC.
Andrea E. Klein, Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Jacqueline L. Babb, Orlando Health Heart and Vascular Institute, Orlando, FL.
Mirza S. Baig, Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Melissa L. Kirkwood, Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Carlos H. Timaran, Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.

Document Type

Journal Article

Publication Date

10-1-2025

Journal

Journal of vascular surgery cases and innovative techniques

Volume

11

Issue

5

DOI

10.1016/j.jvscit.2025.101874

Keywords

Abdominal aorta; EVAR; Iliac artery; Laser fenestration

Abstract

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.

APA Citation

Tanenbaum, Mira T.; Klein, Andrea E.; Babb, Jacqueline L.; Baig, Mirza S.; Kirkwood, Melissa L.; and Timaran, Carlos H., "Endovascular aortic repair endograft limb misdeployment salvaged with laser fenestration" (2025). GW Authored Works. Paper 8337.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8337

Department

School of Medicine and Health Sciences Resident Works