CardioVascular and Interventional Radiology

, Volume 42, Issue 4, pp 608–614 | Cite as

Catheter-Directed Fenestration for Branch Vessel Reconnection in Aortic Dissection Using a Novel Diamond-Tipped Chronic Total Occlusion Drilling Device: A Technical Report

  • Rim Ghali
  • Julian MaingardEmail author
  • Hong Kuan Kok
  • George Matalanis
  • Siven Seevanayagam
  • Hamed Asadi
  • Duncan Mark Brooks
Technical Note



Aortic dissection is a complex condition with high morbidity and mortality. Endovascular treatments including percutaneous fenestration can be used to manage branch vessel ischaemia or risk of aortic rupture. A variety of techniques for aortic fenestration have been described. We describe the novel use of the TruePath Chronic Total Occlusion (CTO) device for aortic intimal fenestration to achieve side branch reconnection.

Materials and Methods

We present three cases of aortic dissection presenting with symptoms of aortic side branch occlusion and end organ malperfusion, treated with aortic fenestration using the TruePath CTO device via trans-brachial and trans-femoral approaches.


Technical success was achieved in all three cases. No complications were encountered. Flow was restored in compromised visceral branches. Branches remained patent on follow-up CT angiography over a minimum 2.5-year follow-up period.


Percutaneous aortic fenestration techniques enable a minimally invasive approach to treat visceral branch malperfusion associated with aortic dissection. The TruePath CTO device improves the control of the fenestration procedure with the potential to improve efficacy and safety.


Aortic dissection Intimal fenestration False lumen True lumen Endovascular 


Compliance with Ethical Standards

Conflict of interest

We declare that we have no conflict of interest.


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Copyright information

© Crown 2018

Authors and Affiliations

  1. 1.Interventional Radiology Service - Department of RadiologyAustin HospitalHeidelberg, MelbourneAustralia
  2. 2.Department of RadiologyNorthern HospitalEppingAustralia
  3. 3.Department of Cardiac SurgeryAustin HospitalHeidelbergAustralia
  4. 4.Department of ImagingMonash UniversityMelbourneAustralia
  5. 5.Interventional Neuroradiology Service – Radiology DepartmentAustin HospitalMelbourneAustralia
  6. 6.School of Medicine – Faculty of HealthDeakin UniversityWaurn PondsAustralia

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