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Periscope graft

Chris Klonaris, Athanasios Katsargyris, Dimitris Athanasiadis, Theodor Liakakos
PURPOSE: To report endovascular treatment of a symptomatic type V thoracoabdominal aortic aneurysm (TAAA) using the combined techniques of endovascular aneurysm sealing and parallel stent-grafts. CASE REPORT: A 70-year-old man was referred with a symptomatic type V TAAA. The Nellix EndoVascular Aneurysm Sealing (EVAS) System was used in combination with 2 chimney grafts for the celiac artery (CA) and the superior mesenteric artery (SMA); one periscope graft perfused the right renal artery...
September 1, 2017: Journal of Endovascular Therapy
Zhi-Yuan Wu, Zuo-Guan Chen, Li Ma, Yong-Peng Diao, Yue-Xin Chen, Chang-Wei Liu, Yue-Hong Zheng, Bao Liu, Yong-Jun Li
BACKGROUND: The chimney/periscope technique has been used to address complex aortic pathologies. This study aimed to report the outcomes and experiences of chimney and/or periscope grafts (CPGs) used in the endovascular management of complex aortic pathologies. METHODS: Twenty-two patients with complex aortic pathologies were retrospectively studied from January 2013 to August 2016 in two vascular centers of teaching hospitals. All patients were diagnosed using computed tomography angiography (CTA)...
September 5, 2017: Chinese Medical Journal
F Pecoraro, M Lachat, N S Cayne, D Pakeliani, Z Rancic, G Puippe, F J Criado, T Pfammatter, F J Veith, B Krüger, T A Neff
PURPOSE: Report mid-term outcomes of thoracic endovascular aneurysm repair (TEVAR) with chimney and periscope grafts (CPG) in supra-aortic branches (SAB). METHODS: Retrospective analysis, from October 2009 to May 2014, of patients with aneurysms requiring TEVAR with zone 0/1/2 proximal landing in association with at least one CPG in the SAB. All patients were considered at high risk for conventional surgery. Peri-operative mortality and morbidity, retrograde type A dissection, maximum aortic transverse diameter (TD) and its post-operative evolution, endoleak, survival, freedom from cardiovascular re-interventions, and CPG freedom from occlusion during the follow-up were analysed...
September 2017: European Journal of Vascular and Endovascular Surgery
Feng Gao, Qian Zeng, Fangming Lin, Xiaohu Ge
OVERVIEW: To describe a new endovascular procedure for acute type A aortic dissection (TAAD) repair. METHODS: Between 2013 and 2016, 12 patients (average age 54±9.6 years; 10 men) with acute TAAD (mean EURO score 11.4%±3.2%, range 5-17) and unfit for surgery underwent thoracic endovascular aortic repair (TEVAR) with 2 periscope grafts to preserve blood supply to supra-aortic branches plus bypass grafting as needed. If the ascending aorta was dilated to >40 mm, sternotomy was performed to wrap the ascending aorta and reduce its diameter to accommodate the aortic stent-grafts...
October 2017: Journal of Endovascular Therapy
Xiangjiu Ding, Sanyuan Hu, Jianjun Jiang
A type B aortic dissection with an aberrant right subclavian artery is an uncommon entity. Most cases have been treated by open or hybrid surgery. We present a case that was managed by endovascular aortic repair with the periscope technique. A thoracic stent graft was implanted into the aortic arch beyond the origin of the right subclavian artery. Two overlapping periscope grafts were placed to maintain perfusion to the right subclavian artery. The presented technique is a feasible and minimally invasive approach for this rare entity...
July 5, 2017: Annals of Vascular Surgery
Felice Pecoraro, Mario Lachat, Michael Hofmann, Neal S Cayne, Lyubov Chaykovska, Zoran Rancic, Gilbert Puippe, Thomas Pfammatter, Nicola Mangialardi, Frank J Veith, Dominique Bettex, Francesco Maisano, Thomas A Neff
OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
F Pecoraro, F J Veith, G Puippe, B Amman-Vesti, D Bettex, Z Rancic, T Pfammatter, M Lachat
OBJECTIVE: The aim was to report on chimney and periscope grafts (CPGs) and their mid- and longer-term outcomes when they are used to preserve reno-visceral artery (RVA) perfusion in endovascular repair of pararenal (PRAAs) or thoraco-abdominal aortic aneurysm (TAAAs). In addition, factors associated with CPG failure are presented. Limited data exist on the outcomes of CPGs, and mid- and long-term results are generally not reported. METHODS: This was a prospective study in a cohort of 100 patients with PRAA (69) or TAAA (31)...
May 2016: European Journal of Vascular and Endovascular Surgery
Bernardo C Mendes, Gustavo S Oderich, Leonardo Reis de Souza, Peter Banga, Thanila A Macedo, Randall R DeMartino, Sanjay Misra, Peter Gloviczki
OBJECTIVE: This study evaluated renal artery (RA) and accessory renal artery (ARA) anatomy and implications for endovascular repair using fenestrated, branched, or parallel (chimney, snorkel, and periscope) stent graft techniques. METHODS: We analyzed the digital computed tomography angiograms of 520 consecutive patients treated by open or fenestrated endovascular repair for complex abdominal aortic aneurysms (2000-2012). RA/ARA anatomy was assessed using diameter, length, angles, and kidney perfusion based on analysis of estimated volumetric kidney parenchyma...
May 2016: Journal of Vascular Surgery
Francesco Setacci, Felice Pecoraro, Lyubov Chaykovska, Nicola Mangialardi, Masami Shingaki, Frank J Veith, Zoran Rancic, Mario Lachat
OBJECTIVE: This study reports our initial experience with the Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) for staged hybrid open renovisceral debranching and endovascular aneurysm repair in patients affected by thoracoabdominal aortic aneurysms and pararenal abdominal aortic aneurysms (PAAAs). METHODS: Between December 2012 and December 2013, we analyzed outcomes of 13 patients who underwent open surgical debranching of renovisceral vessels for thoracoabdominal aortic aneurysm and PAAAs...
July 2016: Journal of Vascular Surgery
Onur Ergun, Murat Canyiğit, Mete Hıdıroğlu, İdil Güneş Tatar, Erdem Birgi, Aslıhan Küçüker, Emrah Uğuz, Hasan Ali Durmaz, Hüseyin Çetin, Baki Hekimoğlu, Erol Şener
BACKGROUND: This study aimed to present our experience in patients with acute traumatic thoracic aortic transection treated by endovascular stent-graft. METHODS: From October 2011 to October 2014, eleven patients were brought to our hospitals after suffering motor vehicle accident or fall from height. Computed tomography revealed acute traumatic transection of the thoracic aorta at the aortic isthmus just distal to the left subclavian artery in nine patients, at the middle or distal thoracic aorta in two, and both aortic isthmus and middle thoracic aorta in one...
July 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
B Lindblad, A Bin Jabr, J Holst, M Malina
BACKGROUND: The chimney graft (CG) technique was introduced to rescue accidentally covered aortic branches during aortic endovascular repair. It extends the sealing zone. There is concern about "gutter" type I endoleak (EL-I) and about the durability of CGs. The aim of the present report was to analyze the rapidly increasing existing data. METHODS: A search was performed (PRISMA criteria) for all studies of visceral and thoracic/arch chimney grafts. Technical and clinical details and outcome were assessed...
December 2015: European Journal of Vascular and Endovascular Surgery
Konstantinos P Donas, Diego Telve, Giovanni Torsello, Georgios Pitoulias, Arne Schwindt, Martin Austermann
OBJECTIVE: The aim of this study was the evaluation of the clinical and radiologic outcomes of parallel grafts in the treatment of patients with failed prior endovascular aneurysm repair and type Ia endoleak. METHODS: Prospectively collected clinical and radiologic data of consecutive patients with prior endovascular aneurysm repair and evidence of type Ia endoleak were analyzed. All patients were treated between January 2009 and November 2014 by use of parallel grafts, ie, chimney/snorkel or periscope grafts and abdominal endovascular devices...
September 2015: Journal of Vascular Surgery
Gabriele Piffaretti, Gianpaolo Carrafiello, Anna Maria Ierardi, Giovanni Mariscalco, Edoardo Macchi, Patrizio Castelli, Matteo Tozzi, Marco Franchin
The aim of this study is to report the use of thoracic endovascular aortic repair (TEVAR) in blunt thoracic aortic injuries (BTAIs) presenting with complex anatomies of the aortic arch vessels. Two patients were admitted to our hospital for the management of BTAI. Anomalies were as follow: aberrant right subclavian artery (n = 1) and right-sided aortic arch with 5 vessels anatomy variant (n = 1). TEVAR was accomplished using parallel graft with periscope configuration in the patient with the aberrant right subclavian artery...
August 2015: Annals of Vascular Surgery
A Chaudhuri
No abstract text is available yet for this article.
July 2015: European Journal of Vascular and Endovascular Surgery
Nunzio Montelione, Felice Pecoraro, Gilbert Puippe, Lyubov Chaykovska, Zoran Rancic, Thomas Pfammatter, Dieter Mayer, Beatrice Amann-Vesti, Marc J Husmann, Frank J Veith, Nicola Mangialardi, Mario Lachat
PURPOSE: To evaluate the midterm outcomes of chimney and/or periscope grafts (CPGs) in patients presenting type I endoleak after a previous endovascular aneurysm repair (EVAR). METHODS: Between June 2002 and April 2014, 24 consecutive patients (mean age 73.9±9.2 years; 23 men) presenting a type I endoleak were addressed with CPGs to extend the proximal and/or distal landing zone and to maintain side branch perfusion. Indication for treatment was a type Ia endoleak in 23 (96%) patients and a type Ib endoleak in one...
August 2015: Journal of Endovascular Therapy
Murat Canyigit, Mete Hidiroglu, Emrah Uguz, Huseyin Cetin
Parallel endografts such as "chimney" and "periscope" are being increasingly used to maintain blood flow to visceral and supra-aortic branches in patients with different aortic disorders. We present a new technique, "iliorenal periscope graft", in a patient with abdominal aortic aneurysm undergoing endovascular aortic repair. In this case, left accessory renal artery flows were provided by an iliorenal periscope graft that extends from the left accessory renal artery to the right common iliac artery in a retrograde fashion...
July 2015: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
G Panuccio, T Bisdas, B Berekoven, G Torsello, M Austermann
OBJECTIVE/BACKGROUND: Bridging stent grafts (BSGs) are used to connect the target vessel with the main body during fenestrated or branched aortic endografting (f/bEVAR). No dedicated devices are available for BSG. The aims of this study were to assess the performance of BSGs. METHODS: Between January 2004 and May 2014 the data of patients treated with f/bEVAR were prospectively collected. Only patients treated after January 2010 were included. The main measurement outcome was any BSG related complications...
July 2015: European Journal of Vascular and Endovascular Surgery
Masaki Tsukashita, Ralph S Mosca
Given the purported hemodynamic advantages of the right ventricle (RV) to pulmonary artery (PA) conduit, many surgeons have adopted it as their preferred source of pulmonary blood flow during stage I palliation for hypoplastic left heart syndrome. Potential disadvantages of the RV-PA shunt include ventricular dysfunction, pseudoaneurysm formation, arrhythmia, and conduit obstruction, which can lead to a higher rate of unplanned reinterventions. The "dunk" technique was described to reduce the RV incision and proximal conduit obstruction; however, insertion of the ringed graft from the epicardium can be cumbersome and risk RV injury...
December 2014: Annals of Thoracic Surgery
Mark G Davies
Renal insufficiency is a risk factor for mortality and morbidity during endovascular aneurysm repair. Multiple changes in practice have occurred to mitigate renal injury and renal dysfunction. Transrenal fixation does carry an increased risk of a decline in renal function in the medium term. Renal stenting for athero-occlusive disease during endovascular aneurysm repair needs careful consideration, as indications have changed and there are unexpected consequences with early vessel occlusion. The growing number of renal interventions during complex endovascular aneurysm repair with the advent of chimney snorkel/periscope techniques and the introduction of fenestrated grafts has shown the resilience of the intervention with relatively low renal issues (approximately 10%), but has also illustrated the need for additional device development...
December 2013: Seminars in Vascular Surgery
Brant W Ullery, Jason T Lee
Endovascular aneurysm repair has taken over open surgery as the primary strategy for treatment of patients with abdominal and thoracic aneurysms. The minimally invasive nature of these techniques requires alterations in preoperative workup, intraoperative management, and familiarity with unique complications that can occur. Familiarity from the anesthetic standpoint of endovascular techniques, including treatment of patients with fenestrated, chimney, snorkel, and periscope grafts, is necessary for the contemporary cardiac anesthesiologist...
September 2014: Anesthesiology Clinics
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