<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000200149</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Fenestração da lâmina de disseção com agulha TIPS, uma técnica adjuvante no tratamento endovascular de aneurismas dissecantes da aorta toraco-abdominal]]></article-title>
<article-title xml:lang="en"><![CDATA[Dissection flap fenestration with TIPS needle, an adjuvant techniquein endovascular treatment of toracoabdominal aortic dissecting aneurysms]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Catarino]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vieira]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bento]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garcia]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pais]]></surname>
<given-names><![CDATA[Fábio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[Tiago]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[Gonçalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[Frederico Bastos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Maria Emília]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário Lisboa Central Serviço de Angiologia e Cirurgia Vascular Hospital de Santa Marta]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>2</numero>
<fpage>149</fpage>
<lpage>151</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000200149&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000200149&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000200149&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Na dissecção crónica complicada de degeneração aneurismática, é frequente existirem fendas espontâneas entre o verdadeiro e o falso lúmen ao nível das artérias viscerais. No entanto, na sua ausência ou difícil identificação, o tratamento com recurso a f/bEVAR está limitado. Nesses casos, pode ser necessária a criação de fenestrações para permitir o acesso aos vasos viscerais.  Métodos / Resultados:  Apresentam-se 2 casos de procedimentos de fenestração de lâmina de disseção crónica em doentes submetidos num segundo tempo a f/bEVAR. Em ambos os doentes, os exames de follow-up a 1 ano mostram permeabilidade das endopróteses e ramos viscerais da aorta, redução do saco aneurismático e ausência de sinais de disseção ou endoleaks.  Conclusões:  Na criação de fenestrações, a rigidez da lâmina de disseção crónica pode requer a utilização de dispositivos grosseiros com risco acrescido de rotura aórtica, como a agulha de TIPS. Para prevenir essa complicação, além do meticuloso planeamento pré-operatório por angio-TC, é essencial a correta identificação intra-operatória do verdadeiro e falso lúmen recorrendo a IVUS ou a angiografia do duplo lúmen aórtico. Nos casos apresentados, a referida técnica foi eficaz.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  In chronic aortic dissection complicated with aneurysmal degeneration, there are commonly spontaneous tears between true and false lumen at the level of visceral arteries. However, in its absence or difficult identification, treatment with f/bEVAR is limited. In these, it may be required a fenestration procedure to allow visceral vessels access.  Methods / Results:  We present two case-reports of patients that underwent dissection flap fenestration procedures followed by f/bEVAR. In both patients, one-year follow-up CT scans show endoprosthesis and visceral branches patency, reduction of aneurysmal sac and absence of dissection or endoleaks.  Conclusions:  In fenestration creation, chronic dissection flap rigidity may require coarse devices with increased risk of aortic rupture, as TIPS needle. To prevent this complication, besides meticulous preoperative planning by CT angiography, intraoperative identification of true and false lumen using IVUS or double aortic lumen angiography is required. In presented cases, this technique was effective.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Disseção crónica]]></kwd>
<kwd lng="pt"><![CDATA[Aneurisma da aorta toraco-abdominal]]></kwd>
<kwd lng="pt"><![CDATA[Flap de disseção]]></kwd>
<kwd lng="pt"><![CDATA[Fenestração]]></kwd>
<kwd lng="pt"><![CDATA[Agulha TIPS (transjugular intrahepatic portosystemic shunt)]]></kwd>
<kwd lng="pt"><![CDATA[Endoprótese]]></kwd>
<kwd lng="pt"><![CDATA[Fenestrated/branched endovascular aortic repair (f/bEVAR)]]></kwd>
<kwd lng="en"><![CDATA[Chronic dissection]]></kwd>
<kwd lng="en"><![CDATA[Thoracoabdominal aortic aneurysm]]></kwd>
<kwd lng="en"><![CDATA[Dissection flap]]></kwd>
<kwd lng="en"><![CDATA[Fenestration]]></kwd>
<kwd lng="en"><![CDATA[TIPS (transjugular intrahepatic portosystemic shunt) needle]]></kwd>
<kwd lng="en"><![CDATA[Endoprosthesis]]></kwd>
<kwd lng="en"><![CDATA[Fenestrated/branched endovascular aortic repair (f/bEVAR)]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fenestração da lâmina de disseção com agulha TIPS, uma técnica adjuvante no tratamento endovascular de aneurismas dissecantes da aorta toraco-abdominal]]></article-title>
<source><![CDATA[Ang]]></source>
<year>2021</year>
<volume>17</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>149-51</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
