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Fenestrated stent graft

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https://www.readbyqxmd.com/read/27908677/haemodynamic-variations-of-flow-to-renal-arteries-in-custom-made-and-pivot-branch-fenestrated-endografting
#1
J Ou, A Y S Tang, T L Chiu, K W Chow, Y C Chan, S W K Cheng
OBJECTIVE: This study aimed to investigate variation of blood flow to renal arteries in custom-made and pivot branch (p-branch) fenestrated endografting, using a computational fluid dynamics (CFD) technique. METHODS: Idealised models of custom-made and p-branch fenestrated grafting were constructed on a basis of a 26 mm stent graft. The custom-made fenestration was designed with a 6 mm diameter, while the 5 mm depth renal p-branch was created with a 6 mm inner and 15 mm outer fenestration...
November 28, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27890849/hybrid-treatment-of-a-suprarenal-aortic-aneurysm-with-an-infrarenal-aorto-bifemoral-surgical-graft-and-a-fenestrated-stent-graft
#2
Sebastian Nagel, Athanasios Katsargyris, Kyriakos Oikonomou, Eric L G Verhoeven
PURPOSE: To report a hybrid technique for the treatment of a suprarenal aortic aneurysm (SAA) in a patient with iliac occlusive disease. Initially an infrarenal aorto-bifemoral surgical graft was implanted, followed by deployment of a fenestrated bifurcated stent-graft at the suprarenal part of the aorta. CASE REPORT: A 69-year old man presented with a 51-mm saccular SAA and iliac occlusive disease with intermittent claudication. Both common iliac arteries had been previously treated with kissing stents...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890847/fenestrated-and-branched-stent-grafting-in-complex-aneurysmatic-aortic-disease-a-single-center-early-experience
#3
Georgios D Vourliotakis, Vasileios D Tzilalis, Panagiotis G Theodoridis, Charalampos S Stoumpos, Dimitrios G Kamvysis, Giannis G Kantounakis
PURPOSE: To present our early experience and highlight the technical difficulties associated with the use of fenestrated and branched stent-grafts to treat patients with juxta-, para-renal abdominal aortic aneurysms (AAA) and thoracoabdominal aortic aneurysms (TAAA). METHODS: A prospectively held database maintained at our department, was queried for patients who have undergone branched and fenestrated stent-grafting for AAA or TAAA treatment. Indication for repair, co-morbidity precluding open repair, technical challenges associated with the repair, as well as operative mortality, morbidity and re-intervention rate were evaluated...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890523/fenestrated-endovascular-aneurysm-repair-of-a-stent-graft-induced-new-entry-tear-in-a-patient-with-a-celiacomesenteric-trunk
#4
B Fiorucci, N Tsilimparis
No abstract text is available yet for this article.
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27887855/regional-anesthesia-as-the-anesthetic-of-choice-for-high-risk-surgical-patients-undergoing-repair-of-juxtarenal-aortic-aneurysms-with-fenestrated-stent-grafts
#5
Jesse Manunga, Jessica Titus
Juxtarenal aortic aneurysms (JAAs) have been conventionally treated using open repair with excellent results. Recent approval of fenestrated stent grafts by the United States Food and Drug Administration has given patients with JAAs an alternative for repair. However, most of these procedures are still performed under general anesthesia, making some surgeons reluctant to offer repair to a subset of patients deemed too high risk for general anesthesia. We present three patients with JAAs at high surgical risk, including one patient with a ruptured aneurysm, who were successfully treated using a fenestrated stent graft under regional anesthesia...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27866781/endovascular-repair-of-thoracoabdominal-aortic-aneurysms-using-fenestrated-and-branched-endografts
#6
Gustavo S Oderich, Mauricio Ribeiro, Leonardo Reis de Souza, Jan Hofer, Jean Wigham, Stephen Cha
PURPOSE: The study purpose was to review the outcomes of patients treated for thoracoabdominal aortic aneurysms using endovascular repair with fenestrated and branched stent-grafts in a single center. METHODS: We reviewed the clinical data of the first 185 consecutive patients (134 male; mean age, 75 ± 7 years) treated for thoracoabdominal aortic aneurysms using fenestrated and branched stent-grafts. Graft design evolved from physician-modified endografts (2007-2013) to off-the-shelf or patient-specific manufactured devices in patients enrolled in a prospective physician-sponsored investigational device exemption protocol (NCT 1937949 and 2089607)...
October 22, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27861397/application-of-physician-modified-fenestrated-stent-graft-in-urgent-endovascular-repair-of-abdominal-aortic-aneurysm-with-hostile-neck-anatomy-case-report
#7
Rong Zeng, Wei Ye, Changwei Liu, Xuan Wang, Xiaojun Song, Leng Ni, Bao Liu, Yongjun Li, Yuehong Zheng
BACKGROUND: This study aimed to evaluate the feasibility and effectiveness of the Gore Excluder aortic stent graft (WL Gore & Associates, Inc., Flagstaff, AZ) using the C3 Delivery System after physician modification of fenestration for the urgent treatment of patients with abdominal aortic aneurysm showing hostile neck anatomy. CASE SUMMARY: Three urgent cases of abdominal aortic aneurysm with hostile neck anatomy symptom with abdominal pain were reported. The same fenestration method was applied to align the target superior mesenteric artery and bilateral renal arteries with 1 scallop and 2 fenestrations, followed by the reconstruction of the target artery using a bare-metal stent or stent graft...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27843111/a-comprehensive-review-of-in-situ-fenestration-of-aortic-endografts
#8
REVIEW
M Glorion, R Coscas, R G McWilliams, I Javerliat, O Goëau-Brissonniere, M Coggia
OBJECTIVE: Despite technical advances of fenestrated and branched endografts, endovascular exclusion of aneurysms involving renal, visceral, and/or supra-aortic branches remains a challenge. In situ fenestration (ISF) of standard endografts represents another endovascular means to maintain perfusion to such branches. This study aimed to review current indications, technical descriptions, and results of ISF. METHOD: A review of the English language literature was performed in Medline databases, Cochrane Database, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
November 11, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27823594/off-the-shelf-fenestrated-and-branched-stent-graft-designs-for-abdominal-aortic-aneurysm-repair
#9
REVIEW
Bernardo C Mendes, Animesh Rathore, Mauricio S Ribeiro, Gustavo S Oderich
Endovascular repair of pararenal and thoracoabdominal aortic aneurysms with fenestrated and branched stent grafts has been increasingly utilized with high technical success and low morbidity and mortality. Freedom from branch-related events has been reported at 89% in 5 years, including any branch-related endoleak, stenosis, kink, disconnection, or occlusion. Patient-specific stent grafts have the advantage of fitting patients' anatomy, but require a 6- to 8-week period for customization. Off-the-shelf stent grafts have been developed based on a relative predictability of renal-mesenteric vessels...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823593/snorkel-endovascular-abdominal-aortic-aneurysm-repair-versus-fenestrated-endovascular-aneurysm-repair-is-it-a-competition
#10
REVIEW
Adam Tanious, Jason T Lee, Murray Shames
The endovascular treatment of juxtarenal abdominal aortic aneurysm (AAA) can be performed by either a standard endovascular stent graft with additional snorkle grafts to aorta branches (snorkel endovascular aneurysm repair) or implantation of a fenestrated stent graft (fenestrated endovascular aneurysm repair). While many vascular surgeons consider snorkel endovascular aneurysm repair and fenestrated endovascular aneurysm repair to be competing techniques or alternate strategies, published procedural outcomes suggest more complementary roles...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823586/infrarenal-endovascular-aneurysm-repair-new-developments-and-decision-making-in-2016
#11
REVIEW
Matthew R Smeds, Kristofer M Charlton-Ouw
New developments in infrarenal abdominal aortic aneurysm stent-graft devices have made more patients eligible for endovascular aneurysm repair (EVAR). Recent US Food and Drug Administration approval for fenestrated endograft repair and impending approval for iliac branch devices extend the proximal and distal landing zones. Better deployment systems allow for partial deployment of endografts to facilitate repositioning, and more flexible designs allow for treatment of angulated infrarenal aneurysm necks and tortuous iliac arteries...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27799273/nationwide-study-of-the-treatment-of-mycotic-abdominal-aortic-aneurysms-comparing-open-and-endovascular-repair
#12
Karl Sörelius, Anders Wanhainen, Mia Furebring, Martin Björck, Peter Gillgren, Kevin Mani
BACKGROUND: -No reliable comparative data exist between open repair (OR) and endovascular repair (EVAR) for mycotic abdominal aortic aneurysms (MAAAs). This nationwide study assessed outcomes after OR and EVAR for MAAA in a population-based cohort. METHODS: -All patients treated for MAAAs in Sweden between1994-2014 were identified in the Swedish vascular registry. The primary aim was to assess survival after MAAA with OR and EVAR. Secondary aims were analyses of the rate of recurrent infections and reoperations, and time-trends in surgical treatment...
October 31, 2016: Circulation
https://www.readbyqxmd.com/read/27798381/endovascular-aneurysm-sealing-evas-and-chimney-evas-in-the-treatment-of-failed-endovascular-aneurysm-repairs
#13
Marwan Youssef, Sebastian Zerwes, Rudolf Jakob, Oroa Salem, Fritz Dünschede, Christian F Vahl, Bernhard Dorweiler
PURPOSE: To assess the technical success and clinical outcome of reinterventions using the Nellix Endovascular Aneurysm Sealing (EVAS) System to treat complications after endovascular aneurysm repair (EVAR). METHODS: Fifteen consecutive patients (mean age 79 years; 14 men) with prior EVAR were treated with EVAS between March 2014 and December 2015 at 2 institutions. The failed prior EVARs included 13 bifurcated endografts, 1 bifurcated graft plus fenestrated cuff, and 1 tube endograft...
October 26, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27793620/concomitant-parallel-endografting-and-fenestrated-experience-in-a-regional-aortic-center
#14
Mathew Wooster, Adam Tanious, Shivangi Patel, Neil Moudgill, Martin Back, Murray Shames
BACKGROUND: Off-label parallel endografting (PE) has been increasingly criticized in favor of on-label custom fenestrated endografts. There remain limited direct comparisons, however, between concurrent patient populations treated by similarly experienced operators. Hence, we seek to evaluate the relative efficacy of the two techniques in treating complex aortic pathology. METHODS: All patients treated by PE or with Cook Zenith Fenestrated (Zfen) devices from January 2010 to June 2015 were reviewed, excluding those treated for rupture...
October 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27687323/midterm-results-from-a-physician-sponsored-investigational-device-exemption-clinical-trial-evaluating-physician-modified-endovascular-grafts-for-the-treatment-of-juxtarenal-aortic-aneurysms
#15
Benjamin W Starnes, Rachel E Heneghan, Billi Tatum
OBJECTIVE: The objective of this study was to report midterm results of an ongoing physician-sponsored investigational device exemption pivotal clinical trial using physician-modified endovascular grafts (PMEGs) for treatment of patients with juxtarenal aortic aneurysms who are deemed unfit for open repair. METHODS: Data from a nonrandomized, prospective, consecutively enrolling investigational device exemption clinical trial were used. Data collection began on April 1, 2011, and data lock occurred on May 31, 2015, with outcomes analysis through December 31, 2015...
September 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27650343/endovascular-repair-of-abdominal-aortic-aneurysms
#16
REVIEW
Dean J Arnaoutakis, Martin Zammert, Alan Karthikesalingam, Michael Belkin
Endovascular repair of abdominal aortic aneurysms is an important technique in the vascular surgeon's armamentarium, which has created a seismic shift in the management of aortic pathology over the past two decades. In comparison to traditional open repair, the endovascular approach is associated with significantly improved perioperative morbidity and mortality. The early survival benefit of endovascular abdominal aortic aneurysm repair is sustained up to 3 years postoperatively, but longer-term life expectancy remains poor regardless of operative modality...
September 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27609737/hybrid-repair-of-thoracoabdominal-aortic-aneurysms-is-a-durable-option-for-high-risk-patients-in-the-endovascular-era
#17
Suvi Väärämäki, Velipekka Suominen, Georg Pimenoff, Jukka Saarinen, Ilkka Uurto, Juha Salenius
OBJECTIVE: To report our long-term experience in using the hybrid technique in complex thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between March 2005 and September 2013, 10 patients with TAAA underwent hybrid procedures with open renovisceral revascularization and thoracoabdominal aortic endografting. Patients were analyzed retrospectively. RESULTS: Six men and 4 women with a mean age of 66 years (range 54-81 years) were treated electively during the study period...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27594350/structural-implications-of-fenestrated-stent-graft-misalignment
#18
S A Crawford, M Itkina, M G Doyle, L W Tse, C H Amon, G Roche-Nagle
BACKGROUND: Endovascular aneurysm repair is a minimally-invasive method for the treatment of abdominal aortic aneurysms. For aneurysms that involve the visceral arteries, a custom-made stent graft with fenestrations for the branch arteries is required. The purpose of the current study is to evaluate the structural impact of misaligned fenestrations with respect to luminal patency and proximal aortic neck apposition in an in vitro model. METHODS: A custom apparatus was used to evaluate seven Anaconda and three Zenith fenestrated stent grafts...
September 1, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27573021/operative-and-midterm-outcomes-of-the-fenestrated-anaconda-stent-graft-in-the-endovascular-treatment-of-juxtarenal-suprarenal-and-type-iv-thoracoabdominal-aortic-aneurysms
#19
Drosos Kotelis, Karina Schleimer, Houman Jalaie, Jochen Grommes, Michael J Jacobs, Johannes Kalder
PURPOSE: To report operative and midterm outcomes of fenestrated endovascular aneurysm repair (FEVAR) with the Anaconda device. METHODS: A retrospective analysis was conducted of 39 consecutive patients (median age 74 years; 36 men) treated with the fenestrated Anaconda stent-graft between July 2011 and December 2015 at a single center. Indications for FEVAR were abdominal aortic aneurysms (AAAs) with neck anatomy unsuitable for a standard stent-graft. Median infrarenal neck length was 4 mm (range 0-9)...
August 29, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27566805/spinal-cord-protection-in-aortic-endovascular-surgery
#20
D A Scott, M J Denton
A persistent neurological deficit, such as paraplegia or paraparesis, secondary to spinal cord injury remains one of the most feared complications of surgery on the descending thoracic or abdominal aorta. This is despite sophisticated advances in imaging and the use of less invasive endovascular procedures. Extensive fenestrated endovascular aortic graft prostheses still carry a risk of spinal cord injury of up to 10%; thus, this risk should be identified and strategies implemented to protect the spinal cord and maintain perfusion...
September 2016: British Journal of Anaesthesia
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