"cheese wire" fenestration of a chronic aortic dissection flap for endovascular repair of a contained aneurysm rupture

Jun Tashiro, Atif Baqai, Lee J. Goldstein, Jason T. Salsamendi, Michele Taubman, Jorge Rey

Research output: Contribution to journalArticle

9 Scopus citations


A 70-year-old man presented with a contained aortic rupture above the aortic bifurcation in the setting of a chronic type B aortic dissection. The celiac and right iliac arteries were supplied by the false lumen, and the superior mesenteric, left iliac, and bilateral renal arteries were supplied by the true lumen. An open repair was not possible due to right-sided heart failure. The "cheese wire" maneuver is a technique used to fenestrate an intimal flap, alleviating malperfusion in aortic dissection. In our modification, a Glidewire (Terumo Medical, Somerset, NJ) was passed across the intimal flap using a Ross Modified Colapinto needle (Cook Medical, Bloomington, Ind) and pulled downward to shear through the membrane to the aortic bifurcation. The fenestration was followed by a unibody endograft stent repair across the contained rupture.

Original languageEnglish (US)
Pages (from-to)497-499
Number of pages3
JournalJournal of vascular surgery
Issue number2
StatePublished - Aug 2014


ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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