“Snare-Ride”: A Bailout Technique to Catheterize Target Vessels With Unfriendly Anatomy in Branched Endovascular Aortic Repair

Ferreira, Marcelo; Katsargyris, Αthanasios; Rodrigues, Eduardo S.; Ferreira, Diego; Cunha, Rodrigo; Bicalho, Guilherme; Oderich, Gustavo S.; Verhoeven, Eric L.G.

doi:10.1177/1526602817709465

Cited by 28 publications

(17 citation statements)

References 7 publications

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“…7 The technical success rate of target vessel revascularization is around 99%; however, this impressive success rate is mostly from series in which the majority of the grafts used were custom-made. 8,9 Certain features of the target vessel, such as posterior location, upward-facing orientation, angulation, and ostial stenosis can compromise stable target vessel catheterization, and a bailout technique, such as the snare-ride technique, 3 is required.…”

Section: Discussionmentioning

confidence: 99%

“…Catheterizing from antegrade branches and obtaining a stable guidewire position can be challenging depending on the rotation of the endograft, the distance from the branch to the target vessel origin, the orientation of the branch, and the angulation of the target vessel. Ferreira et al 3 recently published a bailout technique for bEVAR known as the “snare-ride technique,” in which a snare from a transfemoral access is used to push a wire into the target vessel. In earlier years, an anchoring technique for guiding catheter support in coronary artery interventions was described by Fujita et al 4 The current technical note describes an endovascular bailout “balloon-anchoring” technique to achieve stable target vessel catheterization in complex endovascular aortic repair.…”

Section: Introductionmentioning

confidence: 99%

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Balloon-Anchoring Technique to Stabilize Target Vessel Catheterization in Complex Endovascular Aortic Repair

et al. 2020

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Purpose: To describe a bailout technique to stabilize target vessel catheterization in branched endovascular aortic repair. Technique: The technique is demonstrated in a 75-year-old patient with a 75-mm symptomatic type III thoracoabdominal aortic aneurysm that was treated with a t-Branch endograft. If a catheter cannot be advanced for exchange to a more stable guidewire after target vessel catheterization, the balloon-anchoring technique can be applied to stabilize the through-the-branch hydrophilic guidewire. Through a femoral access a catheter and hydrophilic wire are passed outside the device into the target vessel and exchanged with a stiff wire; a semicompliant balloon is advanced over the Rosen wire and inflated in the target vessel, stabilizing the through-the-branch hydrophilic wire and facilitating its exchange with a stiff wire over a catheter or advancement of the bridging covered stent directly. Conclusion: The balloon-anchoring technique adds to the spectrum of bailout techniques that can be applied in cases of challenging target vessel access.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Balloon-Anchoring Technique to Stabilize Target Vessel Catheterization in Complex Endovascular Aortic Repair

et al. 2020

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“…An often overlooked advantage of this technique is its capacity to adapt to different anatomical challenges that can occur intra-operatively. Whereas with a branched endograft switching from brachial to femoral access would constitute a technical challenge, 10 using PGT the surgeon can easily make an adjustment intra-operatively (Fig. 1).…”

Section: Discussionmentioning

confidence: 99%

Parallel Graft Technique in a Complex Aortic Aneurysm: The Value of Intra-operative Flexibility from The Original Operative Plan

Castro‐Ferreira

Dias

Sampaio

et al. 2019

EJVES Short Reports

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Introduction:The parallel grafting technique (PGT) is a valuable alternative to prefabricated branched or fenestrated endovascular aortic repair. An often overlooked advantage of PGT is its unique adaptability to different anatomical challenges that might appear intra-operatively. Report: A 72 year old male patient presented with a 60 mm thoracic aneurysm, 59 mm juxtarenal abdominal aortic aneurysm, and 32 mm common iliac aneurysm (CIAA). Thoracic endovascular aortic repair plus endovascular aortic repair with bilateral renal artery chimneys and CIAA exclusion applying the sandwich technique was proposed. Because of unfavourable angulation it was not possible to achieve selective left renal catheterisation via axillary access. Changing to a femoral approach allowed successful retrograde catheterisation. The procedure ended with a chimney for the right renal artery and a periscope for the left renal artery. The final angiogram showed no endoleaks and renal and hypogastric patency. The patient was discharged three days after the procedure and remains under ultrasound surveillance after 40 months because of a small type two endoleak. Conclusion: When using a prefabricated branched device, the possibility of selectively catheterising a visceral branch often has no straightforward solution. However, parallel grafting is an extremely flexible technique, which was of paramount importance for the surgical outcome of the present case.

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“…Recently, Ferreira et al presented a technique that is an endovascular bailout for catheterization in difficult visceral vessel anatomy [12]. However, the procedure requires an extra device not commonly used: the Indy Snare (Cook, Bloomington, IN, USA).…”

Section: Discussionmentioning

confidence: 99%

Balloon-grab technique to bridge steep renal artery during endovascular thoracoabdominal aortic aneurysm repair: technical note

Macech

Jakimowicz

Hammer³

et al. 2017

Acta Angiologica

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“Snare-Ride”: A Bailout Technique to Catheterize Target Vessels With Unfriendly Anatomy in Branched Endovascular Aortic Repair

Abstract: The snare-ride technique can be a useful maneuver to catheterize target vessels with difficult anatomy in TAAA branched stent-graft repair. Early experience shows safety and feasibility.

Cited by 28 publications

References 7 publications

Balloon-Anchoring Technique to Stabilize Target Vessel Catheterization in Complex Endovascular Aortic Repair

Balloon-Anchoring Technique to Stabilize Target Vessel Catheterization in Complex Endovascular Aortic Repair

Parallel Graft Technique in a Complex Aortic Aneurysm: The Value of Intra-operative Flexibility from The Original Operative Plan

Balloon-grab technique to bridge steep renal artery during endovascular thoracoabdominal aortic aneurysm repair: technical note

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