Antegrade in situ laser fenestration of aortic stent graft during endovascular aortic repair: A case report

BACKGROUND: The endovascular repair of juxtarenal abdominal aortic aneurysms (JAAA) usually requires combination treatment with various stent graft modifications to preserve side branch patency. As a feasible technique, according to the situation, antegrade in situ laser fenestration still needs to be improved. CASE SUMMARY: This report describes a case that was successfully treated with endovascular repair facilitated by antegrade in situ laser fenestration while maintaining renal arterial flow. Laser fenestration was performed using a steerable sheath positioned in the stent graft lumen in front of the renal artery ostium. With the bare stent region unreleased, renal artery perfusion could be maintained and accurate positioning could be achieved by angiography in real time. CONCLUSION: This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.