Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection

Cecilie Markvard Møller; Steen Fjord Pedersen; Jacob Budtz-Lilly

doi:10.1016/j.ejvsvf.2025.02.003

Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection

Cecilie Markvard Møller^*, Steen Fjord Pedersen, Jacob Budtz-Lilly

^*Corresponding author for this work

Department of Clinical Medicine - Department of Cardiothoracic and Vascular Surgery

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Introduction: Thoracic endovascular aortic repair (T-EVAR) is the standard treatment in patients with a type B aortic dissection and appropriate indications for repair. The procedure requires anatomical, clinical, and technical scrutiny, as well as consideration for potential further repair. Supplementary procedures are not uncommon. Septotomy has received renewed interest as an adjunctive procedure, in the form of electrosurgical techniques, with the objective of improving true lumen landing zones and better access to important target branch vessels. Emerging reports suggest favourable clinical outcomes, although there are associated thromboembolic risks that clinicians should recognise. Case report: This case report describes an important complication of electrosurgical septotomy causing aortic intimal invagination in a patient with a type B aortic dissection. Conclusion: Electrosurgical septotomy is an effective method to gain improved landing zones for TEVAR endograft placement, but caution is warranted in the timing of this procedure.

Original language	English
Journal	EJVES vascular forum
Volume	63
Pages (from-to)	57-60
Number of pages	4
ISSN	2666-688X
DOIs	https://doi.org/10.1016/j.ejvsvf.2025.02.003
Publication status	Published - Jan 2025

Keywords

Aortic dissection
Dissecting abdominal aorta
Dissecting thoracic aorta
Septectomy
Septotomy

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10.1016/j.ejvsvf.2025.02.003Licence: CC BY-NC-ND

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title = "Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection",

abstract = "Introduction: Thoracic endovascular aortic repair (T-EVAR) is the standard treatment in patients with a type B aortic dissection and appropriate indications for repair. The procedure requires anatomical, clinical, and technical scrutiny, as well as consideration for potential further repair. Supplementary procedures are not uncommon. Septotomy has received renewed interest as an adjunctive procedure, in the form of electrosurgical techniques, with the objective of improving true lumen landing zones and better access to important target branch vessels. Emerging reports suggest favourable clinical outcomes, although there are associated thromboembolic risks that clinicians should recognise. Case report: This case report describes an important complication of electrosurgical septotomy causing aortic intimal invagination in a patient with a type B aortic dissection. Conclusion: Electrosurgical septotomy is an effective method to gain improved landing zones for TEVAR endograft placement, but caution is warranted in the timing of this procedure.",

keywords = "Aortic dissection, Dissecting abdominal aorta, Dissecting thoracic aorta, Septectomy, Septotomy",

author = "M{\o}ller, {Cecilie Markvard} and Pedersen, {Steen Fjord} and Jacob Budtz-Lilly",

year = "2025",

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doi = "10.1016/j.ejvsvf.2025.02.003",

language = "English",

volume = "63",

pages = "57--60",

journal = "EJVES vascular forum",

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Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection. / Møller, Cecilie Markvard ; Pedersen, Steen Fjord ; Budtz-Lilly, Jacob.
In: EJVES vascular forum, Vol. 63, 01.2025, p. 57-60.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection

AU - Møller, Cecilie Markvard

AU - Pedersen, Steen Fjord

AU - Budtz-Lilly, Jacob

PY - 2025/1

Y1 - 2025/1

N2 - Introduction: Thoracic endovascular aortic repair (T-EVAR) is the standard treatment in patients with a type B aortic dissection and appropriate indications for repair. The procedure requires anatomical, clinical, and technical scrutiny, as well as consideration for potential further repair. Supplementary procedures are not uncommon. Septotomy has received renewed interest as an adjunctive procedure, in the form of electrosurgical techniques, with the objective of improving true lumen landing zones and better access to important target branch vessels. Emerging reports suggest favourable clinical outcomes, although there are associated thromboembolic risks that clinicians should recognise. Case report: This case report describes an important complication of electrosurgical septotomy causing aortic intimal invagination in a patient with a type B aortic dissection. Conclusion: Electrosurgical septotomy is an effective method to gain improved landing zones for TEVAR endograft placement, but caution is warranted in the timing of this procedure.

AB - Introduction: Thoracic endovascular aortic repair (T-EVAR) is the standard treatment in patients with a type B aortic dissection and appropriate indications for repair. The procedure requires anatomical, clinical, and technical scrutiny, as well as consideration for potential further repair. Supplementary procedures are not uncommon. Septotomy has received renewed interest as an adjunctive procedure, in the form of electrosurgical techniques, with the objective of improving true lumen landing zones and better access to important target branch vessels. Emerging reports suggest favourable clinical outcomes, although there are associated thromboembolic risks that clinicians should recognise. Case report: This case report describes an important complication of electrosurgical septotomy causing aortic intimal invagination in a patient with a type B aortic dissection. Conclusion: Electrosurgical septotomy is an effective method to gain improved landing zones for TEVAR endograft placement, but caution is warranted in the timing of this procedure.

KW - Aortic dissection

KW - Dissecting abdominal aorta

KW - Dissecting thoracic aorta

KW - Septectomy

KW - Septotomy

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DO - 10.1016/j.ejvsvf.2025.02.003

M3 - Journal article

AN - SCOPUS:105000527474

SN - 2666-688X

VL - 63

SP - 57

EP - 60

JO - EJVES vascular forum

JF - EJVES vascular forum

ER -

Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection

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Keywords

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