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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 Heart Institute & Research Centre - Krishna Super Specialty Hospital, 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 Heart Institute & Research Centre - Krishna Super Specialty Hospital, 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