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Fenestrated stent graft

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https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#1
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28428522/-surgeon-modified-fenestrated-thoracic-endovascular-aortic-repair-for-the-treatment-of-aortic-aneurysm
#2
Kenichi Hashizume, Hideyuki Shimizu
Thoracic endovascular aortic repair( TEVAR) for thoracic aortic aneurysm has been established as a 1st-line therapy, especially in high-risk cases, with device improvements and the appearance of various procedures, but there are still cases of anatomical adaptation. On the other hand, several countermeasures have been developed, but there are no commercially available devices for fenestrated or branched stent grafts in Japan. Moreover, complications such as cerebral infarction, organ ischemia and bypass occlusion and infection are pointed out in popular debranch TEVAR...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28401533/long-term-follow-up-of-fenestrated-endovascular-repair-for-juxtarenal-aortic-aneurysm
#3
I N Roy, A M Millen, S M Jones, S R Vallabhaneni, J R H Scurr, R G McWilliams, J A Brennan, R K Fisher
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) is increasingly being used for juxtarenal aortic aneurysms. The aim of this study was to review long-term results and assess the importance of changing stent-graft design on outcomes. METHODS: This was a retrospective review of all patients who underwent FEVAR within a single unit over 12 years (February 2003 to December 2015). Kaplan-Meier analysis of survival, and freedom from target vessel loss, aneurysm expansion, graft-related endoleak and secondary intervention was performed...
April 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28390918/dynamic-geometric-analysis-of-the-renal-arteries-and-aorta-following-complex-endovascular-aneurysm-repair
#4
Brant W Ullery, Ga-Young Suh, John J Kim, Jason T Lee, Ronald L Dalman, Christopher P Cheng
INTRODUCTION: Aneurysm regression and target vessel patency during early and mid-term follow-up may be related to the effect of stent graft configuration on the anatomy. We quantified geometry and remodeling of the renal arteries and aneurysm following fenestrated (F-) or snorkel/chimney (Sn-) endovascular aneurysm repair (EVAR). METHODS: 29 patients (mean age, 76.8±7.8 years) treated with F- or Sn-EVAR underwent computed tomography angiography at pre-op, post-op, and follow-up...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390917/thoracic-endovascular-aortic-repair-into-the-false-lumen-in-chronic-aortic-dissection
#5
Arnoud V Kamman, David M Williams, Himanshu J Patel
PURPOSE: We present two different cases of chronic aortic dissection, where we opted to land the stent graft into the false lumen to treat the associated aneurysm. CASE DESCRIPTIONS: For the first case, the goal of thoracic endovascular aortic repair (TEVAR) was to exclude the aneurysm from within the false lumen, because of a slit-like true lumen. In the second case, the visceral arteries came off the false lumen, with the renal vessels from the true lumen. False lumen TEVAR was performed and the infra-renal aorta fenestrated, as to ensure adequate perfusion...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389292/laparoscopic-transarterial-embolization-of-type-ii-endoleak-after-branched-fenestrated-thoracoabdominal-aortic-aneurysm-endovascular-repair
#6
Gian Franco Fadda, Holta Kasemi, Costantino Luca Di Angelo, Carlo De Nisco, Francesco Balestra, Antonio Cruccu, Mario Marino
Type II endoleak is the most frequent procedure-related complication during endovascular aneurysm exclusion. Actually there is little controversy in the management of type I and III endoleak, while type II endoleak still generates conflicting reports about their timing and type of treatment. Currently, the intervention is needed only in case of sac enlargement, but not in case of persistent endoleak alone. We report the case of a 77 year-old man treated with a custom-made branched/fenestrated endograft for a type III thoracoabdominal aortic aneurysm...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28382077/safety-and-efficacy-of-an-aortic-arch-stent-graft-with-window-shaped-fenestration-for-supra-aortic-arch-vessels-an-experimental-study-in-swine
#7
Jong Ha Park, Han Cheol Lee, Jeong Cheon Choe, Sang-Pil Kim, Tae Sik Park, Jinhee Ahn, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Kwang Soo Cha
BACKGROUND AND OBJECTIVES: Thoracic endovascular aortic repair exhibits limitations in cases where the aortic pathology involves the aortic arch. We had already developed a fenestrated aortic stent graft (FASG) with a preloaded catheter for aortic pathology involving the aortic arch. FASG was suitable for elective cases. MATERIALS AND METHODS: An aortic arch stent graft with a window-shaped fenestration (FASG-W) for supra-aortic arch vessels is suitable for emergent cases...
March 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28376705/a-double-nellix-and-chimney-covered-stents-challenging-treatment-of-pararenal-aortic-aneurysm
#8
Nazzareno Stella, Roberta Ficarelli, Raffaele Dito, Domitilla Brancadoro, Michele Rossi, Maurizio Taurino
A 77-year-old male patient presented with a symptomatic, 66-mm pararenal aortic aneurysm. The patient was classified as unsuitable for open surgery due to significant comorbidities. Fenestrated or branched endografts were contraindicated due to the poor iliac access (6 mm diameter). A double Nellix with chimney endovascular aneurysm sealing (ChEVAS) technique was selected to exclude the pararenal aortic aneurysm and to preserve renal arteries and the superior mesenteric artery. Technical preplanning considered the ideal proximal landing zone to be close to the origin of the almost occluded celiac trunk and the distal common iliac arteries as the ideal distal landing zone...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28374492/in-vitro-laser-fenestration-of-aortic-stent-grafts-a-qualitative-analysis-under-scanning-electron-microscope
#9
Jing Lin, Naval Udgiri, Robert Guidoin, Jean Panneton, Xiaoning Guan, Maxime Guillemette, Lu Wang, Jia Du, Dajie Zhu, Mark Nutley, Ze Zhang
In situ fenestration of stent-grafts allows patients with life threatening aortic pathologies to be amenable to emergent "off the shelf indications for use" percutaneous treatments as a bail out technique. Three types of aortic stent-grafts were subjected to laser fenestration in a physiological saline solution followed by balloon angioplasty using 8, 10 or 12 mm in diameter noncompliant balloons. The morphology and the size of fenestrations were observed under optical and scanning electron microscopy. The damage to the fabrics was analyzed and quantified...
November 2016: Artificial Organs
https://www.readbyqxmd.com/read/28359794/multilayered-parallel-endografting-for-urgent-endovascular-repair-of-a-severely-angulated-thoracoabdominal-aortic-aneurysm
#10
Sukgu M Han, Sarah Wartman, Sung W Ham, Eric C Kuo, Vincent L Rowe, Fred A Weaver
Total endovascular repair of TAAA using branched, fenestrated stent grafts have been performed with promising midterm results. However, severe angulation of the aorta as well as close proximity of the visceral and renal artery ostia pose a significant technical challenge in designing and implanting branched, fenestrated stent grafts. Parallel grafting offers an alternative technique, allowing an urgent, or emergent total endovascular repair of symptomatic, or ruptured TAAA. We describe a technique of 4-vessel incorporation in a total endovascular repair of TAAA, using multilayered parallel endografting via bilateral femoral and unilateral brachial access...
March 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28359715/simplified-total-aortic-arch-replacement-with-an-in-situ-stent-graft-fenestration-technique-for-acute-type-a-aortic-dissection
#11
Xiaoping Hu, Zhiwei Wang, Zongli Ren, Rui Hu, Hongbing Wu
OBJECTIVE: Total arch replacement combined with stented elephant trunk implantation in the descending aorta has successfully improved the outcomes of acute type A aortic dissection (AAAD). However, the optimal surgical strategy for the left subclavian artery (LSA) during the procedure remains a challenge. This study aimed to present our new technique of in situ stent graft fenestration to simplify the surgical procedure for suitable cases of AAAD. METHODS: From August 2008 to December 2015, a total of 106 patients underwent simplified total aortic arch replacement with an in situ stent graft fenestration technique...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28342523/early-experience-with-a-modified-preloaded-system-for-fenestrated-endovascular-aortic-repair
#12
Blandine Maurel, Tim Resch, Rafaelle Spear, Blayne Roeder, Umberto M Bracale, Stephan Haulon, Tara M Mastracci
OBJECTIVE: Preloaded endovascular delivery systems expand the anatomic eligibility for complex aortic repair by requiring only one iliac access vessel and providing a stable platform for guiding sheaths into challenging target vessels. This article reports the lessons learned and early clinical outcomes using a modified preloaded delivery system for fenestrated endovascular aneurysm repair (FEVAR) in three aortic centers in Europe. METHODS: From October 2015 to March 2016, consecutive patients presenting with extensive aortic aneurysm treated with a modified preloaded FEVAR were prospectively enrolled from three high volume European aortic centers...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28335705/commentary-outcome-of-fenestrated-stent-graft-repair-for-abdominal-aortic-aneurysms
#13
Arjan W J Hoksbergen
No abstract text is available yet for this article.
April 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28329032/early-and-mid-term-outcomes-of-endovascular-and-open-surgical-repair-of-non-dissected-aortic-arch-aneurysm%C3%A2
#14
Daijiro Hori, Homare Okamura, Takahiro Yamamoto, Satoshi Nishi, Koichi Yuri, Naoyuki Kimura, Atsushi Yamaguchi, Hideo Adachi
OBJECTIVES: With the introduction of endovascular stent graft technology, a variety of surgical options are available for patients with aortic aneurysms. We sought to evaluate early-term and mid-term outcomes of patients undergoing endovascular and open surgical repair for non-dissected aortic arch aneurysm. METHODS: Overall, 200 patients underwent treatment for isolated non-dissected aortic arch aneurysm between January 2008 and February 2016: 133 patients had open surgery and 67, endovascular repair...
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28314672/fenestration-of-a-papyrus-pk-covered-stent-to-recover-the-occluded-left-main-bifurcation-after-sealing-a-left-main-perforation-during-a-cto-procedure
#15
Gerald S Werner, Waqar H Ahmed
Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia...
March 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28285957/comparison-of-renal-outcomes-in-patients-treated-by-zenith-%C3%A2-fenestrated-and-zenith-%C3%A2-abdominal-aortic-aneurysm-stent-grafts-in-us-prospective-pivotal-trials
#16
L R de Souza, G S Oderich, M A Farber, S Haulon, P V Banga, A H Pereira, P Gloviczki, S C Textor, F Jia
OBJECTIVE/BACKGROUND: Fenestrated endovascular repair (FEVAR) has been used to treat complex abdominal aortic aneurysms (AAAs). The risk of renal function deterioration compared with infrarenal endovascular aortic repair (EVAR) has not been determined. METHODS: Patients with preserved renal function (estimated glomerular filtration rate [eGFR] > 45 mL/minute) enrolled in two prospective, non-randomised studies evaluating Zenith fenestrated and AAA stent grafts were matched (1:2) by propensity scores for age, sex, hypertension, diabetes, and pre-operative eGFR...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28279526/applicability-and-midterm-results-of-branch-cuff-closure-with-vascular-plug-in-branched-endovascular-repair-for-thoracoabdominal-aortic-aneurysms
#17
Kiattisak Hongku, Timothy Resch, Björn Sonesson, Thorarinn Kristmundsson, Nuno V Dias
OBJECTIVE: This study assessed the applicability and outcomes of the closure of unused cuffs in branched endovascular aneurysm repair (b-EVAR) of thoracoabdominal aortic aneurysm. METHODS: We reviewed b-EVAR procedures at a tertiary referral center to identify patients who underwent incomplete branching and needed closure of the unused branch cuffs. An electronic database and intraoperative and follow-up imaging studies were reviewed to assess technical applicability and outcomes...
March 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28269195/mechanical-performances-of-endovascular-aneurysm-repair-strategies-with-main-aortic-and-chimney-grafts
#18
Wei-Ling Chen, Bing-Feng Huang, Ming-Long Yeh, Chung-Dann Kan
The use of endovascular aneurysm repair (EVAR) strategies for the treatment of complex aortic pathologies is a major area of investigation in modern surgery. EVAR strategies using fenestrated or branched devices provide alternatives to open surgery for patients with aortic pathologies with visceral branch involvement, but their applications have some major limitations. To extend endovascular repair to patients whose anatomy is unfit for branched or fenestrated stent grafts or open repair, parallel graft techniques using chimney grafts (CGs) have been proposed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28259569/utility-and-safety-of-axillary-conduits-during-endovascular-repair-of-thoracoabdominal-aneurysms
#19
Jordan R Stern, Sharif H Ellozy, Peter H Connolly, Andrew J Meltzer, Darren B Schneider
OBJECTIVE: Endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs) with branched and fenestrated stent grafts often requires upper extremity arterial access for antegrade delivery of bridging covered stents into the visceral arteries. Axillary, brachial, and radial artery approaches have been described, but data on the safety and utility of the different approaches remain limited. We have preferentially used axillary artery conduits for upper extremity arterial access during endovascular repair of TAAA and describe our technique and report our experience herein...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28258015/influence-of-anatomic-angulations-in-chimney-and-fenestrated-endovascular-aneurysm-repair
#20
Caroline Caradu, Xavier Bérard, Dominique Midy, Eric Ducasse
BACKGROUND: Fenestrated (F-) endovascular aneurysm repair (EVAR)'s lack of widespread availability encouraged alternative strategies. Chimney graft (CG)-EVAR has spread when costs, manufacturing delays or anatomy preclude F-EVAR. Our objective was to evaluate CG-EVAR and F-EVAR's outcomes depending on the angulation of target renal arteries and hostility of iliac accesses to determine the potential impact of a choice made between the two techniques based upon preoperative anatomic criteria...
February 28, 2017: Annals of Vascular Surgery
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