The End of Wire Wrapping: A Technique to Avoid Intertwining Preloaded Guidewires for Endovascular Aortic Arch Repair.

(1)Hospital Ana Nery, Aorta Team, Universidade Federal da Bahia, Salvador, Brazil.

(2)Hospital Universitário Professor Edgard Santos, Division of Vascular and Endovascular Surgery, Universidade Federal da Bahia, Salvador, Brazil.

(3)Hospital das Clínicas, Vascular and Endovascular Surgery Department, Universidade de São Paulo, São Paulo, Brazil.

PURPOSE: The purpose of this study was to present a new technique for endovascular aortic arch repair for 1, 2, or 3 vessels using preloaded wires and precannulated target vessels without wire wrapping. TECHNIQUE: This technique uses a prototype catheter with 2 parallel lumens to position through-and-through guidewires in the supra-aortic branches and an extra-stiff guidewire in the ascending aorta with no wrapping. This allows the introduction and advancement of the device with the already precannulated target vessels. The endograft is advanced to the aortic arch without twisting or wrapping. Covered stents are deployed to align the graft and target vessels.CONCLUSION: To our knowledge, a technique that avoids wire wrapping has not been previously described. This technique allows safer and faster endovascular arch procedures and opens up new possibilities by enabling multi-vessel endovascular aortic arch repair with all precannulated target vessels.