Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-143
TEVAR in a Severly Calcified and Anormously Tortuous Aorta & Iliacs
By Rohit Mody
Presenter
Rohit Mody
Authors
Rohit Mody1
Affiliation
Mody Harvard Cardiac Institute & Research Centre , India1,
View Study Report
TCTAP C-143
ENDOVASCULAR - Aorta Disease and Intervention
TEVAR in a Severly Calcified and Anormously Tortuous Aorta & Iliacs
Rohit Mody1
Mody Harvard Cardiac Institute & Research Centre , India1,
Clinical Information
Patient initials or Identifier Number
158681
Relevant Clinical History and Physical Exam
86 year old female Breathlessness Hypertensive, Normal BMI, family history of Coronary artery disease severe LV Dysfunction EF- 20-25% Dyslipidemia Malnourished CAD DVD post PCI Creatinine 0.9 Aneusrysm detected during PCI
Relevant Test Results Prior to Catheterization
Hypertensive, Normal BMI, family history of Coronary artery disease severe LV Dysfunction EF- 20-25% Dyslipidemia
Relevant Catheterization Findings
Aortogram showing Abdominal Aortic Aneurysm & severely Calcified & Tortuous Iliacs
Interventional Management
Procedural Step
The procedure was approached through right Brachial cutdown and both Femoral arterial cannulation with 24f arterial sheaths, Our technique with Straightening of Tortuosity with three extra stiff Lunderquist wires from both femoral arteries and one brachial artery. Renal artery also ecstatic protected by buddy wire during graft deployment, Stent Graft positioned , Descending aortic stent graft was deployed with arm in Right Iliac, Separate Stent graft was deployed in Left iliac artery, Abdominal aortic aneurysm covered using 23x16mm Endurant II & then left iliac artery with 16x16mm Endurant II stent graft system, Check angio revealed an Endo-leak, Hence Post Dilatation done with 46mmx100mm Reliant balloon graft at 6 ATM, No endo-leak was observed after post-Dilatation. Good final result.
Case Summary
Our study demonstrates that descending aorta along with iliacs can be treated with stent grafts the chimney technique can be used if renal arteries are covered inadvently. Our technique with Straightening of Tortuosity with three extra stiff Lunderquist wires from both femoral arteries and one brachial artery. We oversized the stent grafts by 20% so as to decrease incidence of endo-leak. This procedure is feasible even in tortuous and severely calcified aortic aneurysms