Cheese Wire Fenestration of a Chronic Juxtarenal Dissection Flap to Facilitate Proximal Neck Fixation during EVAR

Endovascular management of false lumen aneurysms in the setting of chronic dissection is limited by the ability of stent grafts to obtain adequate proximal or distal fixation. Endovascular fenestration of these chronic flaps facilitates generation of suitable landing zones, thereby serving as a useful adjunct to standard EVAR.