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Fenestrated stent graft

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https://www.readbyqxmd.com/read/29780069/successful-rescue-of-a-ruptured-tracheoinnominate-fistula-with-extracorporeal-membrane-oxygenation-endovascular-stents-and-debranching-surgical-bypass
#1
Yu-San Chien, Yen-Chun Chao, Kuo-Sheng Lee, Kung-Hong Hsu
We reported a case of ruptured tracheoinnominate fistula in a 14-year-old boy with history of repeated sternotomy. Tracheostomy was performed at age 2 years. Slide tracheoplasty was done at age 13 years. He presented to outpatient clinic with episodic hemosputum. Massive blood emanated from stoma during bronchoscopy evaluation. Venous-arterial extracorporeal membrane oxygenation was installed for resuscitation. A contrast-enhanced computed tomography (CT) and angiography confirmed the diagnosis. Immediate control of bleeding was achieved by an endovascular stent graft deployed at innominate artery...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29701403/hostile-thoracic-aortic-aneurysm-treated-by-fenestrated-thoracic-stentgraft-with-proximal-sealing-in-ishimaru-zone-0
#2
Joel Sousa, João Neves, Vicente Riambau, José Teixeira
INTRODUCTION: Thoracic endovascular aortic aneurysm repair (TEVAR) is an established treatment for thoracic aortic disease in both the acute and elective setting, with such a widespread use that almost 50% of all thoracic aortic surgery in Europe is performed by these means. Nonetheless, the feasibility of TEVAR is determined by several anatomic factors, and the suitability of the proximal and distal landing zones remain one of the main limitations to its use. The advent of custom-made thoracic stent grafts widened the endovascular options in some challenging anatomies...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701402/endovascular-treatment-of-a-complicated-type-b-acute-aortic-dissection-with-3-d-ultrasound-control
#3
Roger Rodrigues, Javier Villaverde, Jorge Noya, Gabriel Anacleto, Óscar Gonçalves
INTRODUCTION: Acute type B aortic dissection (ATBAD), identified within 2 weeks of symptom onset, accounts for 25%-40% of all aortic dissections. Approximately 25% of patients presenting with ATBAD are complicated at admission by malperfusion syndrome or hemodynamic instability, resulting in a high risk of early death when untreated. METHODS: We present a case of a patient with a complicated type B dissection treated by an endovascular technique with control of the sealing zone with transesophageal Echocardiogram (TEE) and 3-D images...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29692216/laser-fenestration-of-aortic-stent-grafts-followed-by-noncompliant-vs-cutting-balloon-dilation-a-scanning-electron-microscopy-study
#4
Jing Lin, Niraj Parikh, Naval Udgiri, Shaoxia Wang, Daniel F Miller, Chaojing Li, Jean Panneton, Mark Nutley, Ze Zhang, Yunfan Huang, Jun Lu, Jingyi Zhang, Lu Wang, Robert Guidoin
PURPOSE: To examine the effects of in situ laser fenestration and subsequent balloon dilation (noncompliant vs cutting) on the graft fabric of 4 aortic stent-graft models. METHOD: In an in vitro setup, the Zenith TX2, Talent, Endurant, and Anaconda aortic stent-grafts (all made of polyester graft material) were subjected to laser fenestration with a 2.3-mm-diameter probe at low and high energy in a physiologic saline solution followed by balloon dilation of the hole...
April 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29680298/experimental-evaluation-of-homemade-distal-stent-graft-fenestration-for-thoracic-endovascular-aortic-repair-of-type-a-dissection-by-a-transapical-approach
#5
Thomas Gandet, Anis Seghrouchni, Baris Ata Ozdemir, Guillaume Captier, Roland Demaria, Pierre Alric, Bernard Albat, Ludovic Canaud
OBJECTIVE: The use of off-the-shelf stent grafts for thoracic endovascular aortic repair of type A dissections is limited by variability in both the length of the ascending aorta and the location of the proximal intimal tear. This experimental study aimed to assess the feasibility of using a physician-modified thoracic aortic stent graft to treat acute type A dissection by a transapical cardiac approach. METHODS: The experiments were performed on six cadaveric human heart, ascending aorta, aortic arch, and descending aorta specimens...
April 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29665666/-early-results-of-fenestrated-endovascular-aortic-repair-for-the-treatment-of-patients-with-thoracoabdominal-pathologies
#6
J C Zhu, X C Dai, Y D Luo, H L Fan, Z Feng, Y W Zhang, F G Hu
Objective: To evaluate the early results of fenestrated endovascular aortic repair (FEVAR) using physician-modified stent grafts (PMSGs) for the treatment of patients with thoracoabdominal pathologies. Methods: Nineteen consecutive patients who underwent FEVAR using PMSGs between April 2012 and September 2017 were retrospectively reviewed. The modality of FEVAR technique was assessed, perioperative clinical data was recorded and the early results were evaluated. Results: Indications were thoracoabdominal aortic pathologies, including juxtarenal abdominal aortic aneurysm (JAAA) ( n =12), chronic thoracoabdominal aortic dissection with aneurysmal dilatation ( n =3), thoracoabdominal aortic aneurysm (TAAA) ( n =1), infrarenal AAA with an accessory renal artery in the segment of the aneurysmal neck ( n =2) and type Ⅰ endoleak after EVAR for AAA( n =1)...
March 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29642797/recurrent-aortic-dissection-in-a-patient-with-an-actin-mutation-treated-with-a-laser-fenestrated-aortic-arch-stent-graft
#7
J Michael Cullen, Gorav Ailawadi, John F Angle, Matthew Thomas, Gilbert R Upchurch
A 58-year-old African American female, who had previously undergone a valve-sparing aortic root replacement for a type A dissection, represented 2 months later with a new focal dissection and aneurysm with intramural hematoma just distal to the origin of the left subclavian artery. Since no landing zone distal to the subclavian artery existed, the patient underwent thoracic endovascular aortic repair with laser fenestration-aided stent-graft placement in the left subclavian artery. The patient recovered without complication, and 52 months later, she is doing well with normal renal function and ambulatory status...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29557587/fenestrated-endovascular-aortic-repair-and-clinical-trial-devices-for-complex-abdominal-aortic-aneurysms
#8
Clayton J Brinster, Ross Milner
Endovascular aortic repair (EVAR) has revolutionized the treatment of infrarenal abdominal aortic aneurysm (AAA), with consistently low reported perioperative morbidity and mortality. Universal applicability of EVAR to treat AAA is hindered by several specific anatomic constraints, however, and many patients cannot be treated with commercially available stent grafts within the device specific instructions for use. Treatment of these complex pararenal aneurysms is increasingly accomplished by extension of EVAR into the visceral segment of the abdominal aorta with branches or fenestrations that allow perfusion of the visceral and renal arteries...
March 19, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29545020/early-experience-with-the-use-of-inner-branches-in-endovascular-repair-of-complex-abdominal-and-thoraco-abdominal-aortic-aneurysms
#9
Athanasios Katsargyris, Pablo Marques de Marino, Hozan Mufty, Luis Mendes Pedro, Ruy Fernandes, Eric L G Verhoeven
OBJECTIVES: Visceral arteries in fenestrated and branched endovascular repair (F/BEVAR) have been addressed by fenestrations or directional side branches. Inner branches, as used in the arch branched device, could provide an extra option for visceral arteries "unsuitable" for fenestrations or directional side branches. Early experience with the use of inner branches for visceral arteries in F/BEVAR is described. METHODS: All consecutive patients treated by F/BEVAR for complex abdominal aortic aneurysm (AAA) or thoraco-abdominal aneurysm (TAAA) using stent grafts with inner branches were included...
May 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29536780/treatment-for-thoracoabdominal-aortic-aneurysm-by-fenestrated-endovascular-aortic-repair-with-physician-modified-stent-graft
#10
Xin Yang, Xiang-Chen Dai, Jie-Chang Zhu, Yu-Dong Luo, Hai-Lun Fan, Zhou Feng, Yi-Wei Zhang, Fan-Guo Hu
Despite being widely used for several years, the endovascular aortic repair (EVAR) of a thoracoabdominal aneurysm (TAAA) remains challenging, particularly the revascularization of the abdominal aortic visceral branches. A 66-year-old male was admitted to hospital with abdominal bloating and pain. Computed tomographic angiography (CTA) confirmed a Crawford type III TAAA from the distal descending aorta to the suprarenal abdominal aorta that involved the celiac axis, accompanied with an occlusion of the left subclavian artery...
May 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29526427/-acute-aortic-syndromes
#11
REVIEW
Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
February 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29518520/repair-of-delayed-type-1a-endoleak-using-fenestrated-and-parallel-endografts
#12
Neil P Reddy, Sung Wan Ham, Fred A Weaver, Vincent L Rowe, Kenneth R Ziegler, Sukgu M Han
Endovascular aneurysm repair has become the first-line treatment modality for infrarenal aortic aneurysms. However, obtaining successful long-term results frequently requires reinterventions. Particularly, delayed type 1a endoleaks pose a challenging problem, as they are often associated with proximal extension of the aneurysmal process to juxtarenal or pararenal aortic segments. We describe 2 remedial techniques to repair delayed type 1a endoleak by extending the seal zone to the suprarenal aorta, while incorporating the renal arteries...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29511868/technical-note-dissection-flap-perforation-with-use-of-a-tips-needle-during-fenestrated-endografting-for-post-dissection-thoracoabdominal-aneurysms
#13
Hozan Mufty, Athanasios Katsargyris, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven, Geert Maleux
INTRODUCTION: Fenestrated/branched thoracic endovascular aneurysm repair (F/Br-TEVAR) is a new minimal invasive treatment option for patients with post-dissection thoracoabdominal aortic aneurysms. This specific pathology is challenging to F/Br-TEVAR, especially when target vessels originate from the false lumen. Crossing from the true lumen into the false lumen to catheterize such target vessels may prove cumbersome in the usually thickened dissection flap. TECHNIQUE: We describe a bailout technique when standard catheterization techniques fail, by using a transjugular intrahepatic portosystemic shunt (TIPS)-needle to perforate the dissection flap...
June 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29502996/fenestrated-branched-endografts-and-visceral-debranching-plus-stenting-hybrid-for-complex-aortic-aneurysm-repair
#14
Nikolas Tsilimparis, Sebastian E Debus, Max Biehl, Konstantinos Spanos, Axel Larena-Avellaneda, Sabine Wipper, Fiona Rohlffs, Tilo Kölbel
OBJECTIVE: The aim of this study was to assess the immediate postoperative and midterm outcome of complex aortic aneurysm treatment necessitating four-vessel revascularization with either a total endovascular approach (fenestrated-branched stent graft [FBSG]) or a hybrid technique of visceral debranching plus stenting. METHODS: The clinical data of consecutively treated patients presenting with a complex aortic aneurysm that necessitated four-vessel revascularization between 2010 and 2015 were retrospectively analyzed...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29501401/one-year-outcomes-of-101-begraft-stent-grafts-used-as-bridging-stents-in-fenestrated-endovascular-repairs
#15
Rafaelle Spear, Jonathan Sobocinski, Adrien Hertault, Matthieu Delloye, Richard Azzauiu, Dominique Fabre, Stéphan Haulon
OBJECTIVES: To evaluate the outcomes of the second generation BeGraft balloon expandable covered stent Graft System (Bentley InnoMed, Hechingen, Germany) implanted as bridging stent grafts during fenestrated endovascular aortic repair (FEVAR) of complex aneurysms. DESIGN: This was a single centre prospective study including all consecutive patients treated by FEVAR performed with second generation BeGraft stent grafts as bridging stents. METHODS: Demographics of patients, diameter and length of the bridging stent grafts, technical success, re-interventions, occlusions, post-operative events, and imaging (Cone Beam CT and/or CT scan, and contrast enhanced ultrasound) were prospectively collected in an electronic database...
April 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29488648/hybrid-and-total-endovascular-repair-of-the-aortic-arch
#16
REVIEW
N Rudarakanchana, M P Jenkins
BACKGROUND: Recent advances in endovascular technology have enabled minimally invasive repair of the aortic arch, with specifically designed stent-grafts. This article reviews hybrid and total endovascular repair in the management of aortic arch pathology. METHODS: Studies relating to aortic arch management were identified using MEDLINE and Embase, focusing on endovascular repair. RESULTS: Hybrid arch repair is associated with an early mortality rate of some 12 per cent, and carries significant risk of stroke (up to 15 per cent), paraplegia (up to 6 per cent), retrograde dissection (up to 6·5 per cent) and proximal endoleak (6 per cent)...
March 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29488644/case-series-of-aortic-arch-disease-treated-with-branched-stent-grafts
#17
R E Clough, R Spear, K Van Calster, A Hertault, R Azzaoui, J Sobocinski, D Fabre, S Haulon
BACKGROUND: Surgical repair of aortic arch pathology is complex and associated with significant morbidity and mortality. Alternative approaches have been developed to reduce these risks, including the use of thoracic stent-grafts with fenestrations or in combination with bypass procedures to maintain supra-aortic trunk blood flow. Branched stent-grafts are a novel approach to treat aortic arch pathology. METHODS: Consecutive patients with aortic arch disease presenting to a single university hospital vascular centre were considered for branched stent-graft repair (October 2010 to January 2017)...
March 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29481931/the-presence-of-gas-in-aneurysm-sac-during-early-postoperative-period-is-associated-to-the-type-of-endograft-and-perfused-lumen-s-size
#18
Vasileios Saleptsis, Konstantinos Spanos, Nikolaos Tsilimparis, Fiona Rohlffs, Sebastian E Debus, Tilo Kölbel
BACKGROUND: The aim of the present study was to examine the frequency of gas within the aneurysm sac following endovascular aneurysm repair (EVAR) on early postoperative computed tomography (CT) scans, to measure its volume, record the location, and analyze anatomical and procedural risk factors of its presence. METHODS: A retrospective analysis of prospectively collected data of patients undergoing standard, fenestrated, or branched EVAR between January 2013 and December 2015 was undertaken...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477510/one-year-outcomes-of-101-begraft-stent-grafts-used-as-bridging-stents-in-fenestrated-endovascular-repairs-a-bridge-too-far-for-some
#19
Michael P Jenkins
No abstract text is available yet for this article.
April 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29409396/analysis-of-iliac-artery-geometric-properties-in-fenestrated-aortic-stent-graft-rotation
#20
Matthew G Doyle, Sean A Crawford, Elrasheed Osman, Naomi Eisenberg, Leonard W Tse, Cristina H Amon, Thomas L Forbes
INTRODUCTION: A complication of fenestrated endovascular aneurysm repair is the potential for stent graft rotation during deployment causing fenestration misalignment and branch artery occlusion. The objective of this study is to demonstrate that this rotation is caused by a buildup of rotational energy as the device is delivered through the iliac arteries and to quantify iliac artery geometric properties associated with device rotation. METHODS: A retrospective clinical study was undertaken in which iliac artery geometric properties were assessed from preoperative imaging for 42 cases divided into 2 groups: 27 in the nonrotation group and 15 in the rotation group...
April 2018: Vascular and Endovascular Surgery
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