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. 2017 Jul/Aug;12(4):265-268.
doi: 10.1097/IMI.0000000000000392.

Precannulated Fenestrated Endovascular Aneurysm Repair Using Guidewire Fixator: A Novel Method Using the Liungman Guidewire Fixator

Linus Bosaeus  1 , Kevin Mani, Anders Wanhainen, Krister Liungman
Affiliations

Precannulated Fenestrated Endovascular Aneurysm Repair Using Guidewire Fixator: A Novel Method Using the Liungman Guidewire Fixator

Linus Bosaeus et al. Innovations (Phila). 2017 Jul/Aug.

Abstract

Objective: By using a guidewire fixator, the distal guidewire position can be secured in an artery. This new principle enables a method for fenestrated endovascular aortic repair where the connection between the aortic branches and the stent graft fenestrations is made before inserting and deploying the stent graft.

Methods: This is conducted using a fenestrated stent graft with preloaded catheters, through which the prepositioned and distally secured guidewires from the branches are inserted.

Results: This report covers the method when implementing a single fenestration stent graft in pig.

Conclusions: Successful tests with single and dual fenestrated grafts have been conducted in pigs.

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Figures

FIGURE 1
FIGURE 1
Fixator assembly. A, Self-expandable Nitinol fixation element. B, 0.035-in guidewire fitted with a distal stopper that engages with the fixation element. C, Retrieval catheter that is used to delivery and retrieve the fixator through a sheath. D, Torque device to enable easy rotation for detachment and attachment during delivery and retrieval. E, Transparent tube in which the fixator is delivered to access the sheath membrane.
FIGURE 2
FIGURE 2
Fixator functionality. 1, Placement of sheath and LGF guidewire. 2–3, Positioning of the fixation element using the catheter, deployment by retraction of the sheath. 4, Detaching the fixator by counter clockwise rotation on the retrieval catheter. 5, Moderate radial force secures wire position at rest. 6, Distal stopper interaction causes increased anchoring force through expansion upon guidewire tension. 7–10, Fixator retrieval by reversing the delivery steps.
FIGURE 3
FIGURE 3
First, stent graft insertion over the main guiding wire and the LGF guidewire positioned in the renal branch. Second, stent graft in position over the renal branch. Third, stent graft is partially deployed and the LGF guidewire is pulled down to align with the renal branch. Fourth, The fenestration is aligned with the renal branch and the stent graft is deployed completely.
See this image and copyright information in PMC

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