Use of steerable catheters for endovascular procedures: Report of a CASE and literature review

Catheter Cardiovasc Interv. 2020 Apr 1;95(5):971-977. doi: 10.1002/ccd.28380. Epub 2019 Jun 23.

Abstract

We report a case of a celiac trunk stenting using a steerable guiding catheter, to fix a residual endoleak following fenestrated endovascular repair (FEVAR) of a thoraco-abdominal aortic aneurysm (TAAA). A systematic search of the literature about the use of steerable catheters was also performed on Pubmed according to the PRISMA Guidelines, including all papers in which the device was used for in vivo endovascular procedures. In our case report, the patient had undergone a failed attempt of cannulation due to the presence of a severely angulated and stenosed ostium of the vessel. A steerable catheter was then used to fix the residual endoleak. The search of the Literature retrieved 544 papers. Of them, 13 met the inclusion criteria and were therefore assessed. The use of steerable sheaths and catheters was reported as effective and safe for the cannulation of 157 target vessels in 131 endovascular procedures, with a success rate of 95.5% and no complications. The use of a steerable guiding catheter in our experience was safe and effective for the selective cannulation of a severely stenosed and angulated celiac trunk, to correct a residual endoleak after FEVAR for TAAA. Steerable catheters could be useful tools for the selective cannulation of target vessels with a challenging ostium.

Keywords: catheter design; endovascular intervention; surgery, endovascular.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Aged
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / physiopathology
  • Aortic Aneurysm, Thoracic / surgery*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / physiopathology
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / instrumentation*
  • Celiac Artery / diagnostic imaging
  • Celiac Artery / physiopathology
  • Endoleak / diagnostic imaging
  • Endoleak / etiology
  • Endoleak / physiopathology
  • Endoleak / therapy*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Humans
  • Male
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / physiopathology
  • Stents
  • Treatment Outcome
  • Vascular Access Devices*