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Fenestrated stent graft

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https://www.readbyqxmd.com/read/29349408/infolding-of-fenestrated-endovascular-stent-graft
#1
Jason G E Zelt, Prasad Jetty, Adnan Hadziomerovic, Sudhir Nagpal
We report a case of infolding of a fenestrated stent graft involving the visceral vessel segment after a juxtarenal abdominal aorta aneurysm repair. The patient remains free of any significant endoleak, and the aortic sac has shown regression. The patient remains asymptomatic, with no abdominal pain, with normal renal function, and without ischemic limb complications. We hypothesize that significant graft oversizing (20%-30%) with asymmetric engineering of the diameter-reducing ties may have contributed to the infolding...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29342417/a-study-of-the-cost-effectiveness-of-fenestrated-branched-evar-compared-with-open-surgery-for-patients-with-complex-aortic-aneurysms-at-2-years
#2
Morgane Michel, Jean-Pierre Becquemin, Jean Marzelle, Céline Quelen, Isabelle Durand-Zaleski
OBJECTIVES: The aim was to assess the cost-effectiveness of fenestrated and branched stent grafts (f/b EVAR) compared with open surgical repair (OSR) in thoraco-abdominal or complex abdominal aortic aneurysms (TAAA/AAA) at 2 years. METHODS: Two matched cohorts of patients with TAAA or complex AAA were compared after a follow-up of two years. Patients included in the WINDOW French multicentre prospective registry were treated by f/b EVAR, and OSR patients were extracted from the French national hospital discharge database...
January 13, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29313455/preliminary-outcomes-of-the-lifestream-balloon-expandable-covered-stent-in-fenestrated-and-branched-thoracoabdominal-endovascular-repairs
#3
Luca Bertoglio, Diletta Loschi, Tommaso Cambiaghi, Daniele Mascia, Andrea Kahlberg, Germano Melissano, Roberto Chiesa
PURPOSE: To evaluate the 1-year outcomes of thoracoabdominal aortic aneurysm (TAAA) repair using fenestrated and branched stent-grafts and a novel balloon-expandable covered stent. METHODS: Between March 2015 and January 2017, 18 patients (median age 74.7 years; 14 men) received 43 LifeStream balloon-expandable covered stents in conjunction with Zenith fenestrated/branched stent-grafts to bridge 11 celiac trunks, 8 superior mesenteric arteries, and 24 renal arteries (total 32 fenestrations and 11 branches)...
January 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29313454/a-multicenter-experience-with-a-new-fenestrated-branched-device-for-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#4
Marwan Youssef, Sebastien Deglise, Piotr Szopinski, Schäfer Jost-Philipp, Amer Jomha, Christian F Vahl, Ahmed Koshty
PURPOSE: To investigate the outcomes of patients who were treated for thoracoabdominal aortic aneurysms (TAAAs) using custom-made fenestrated-branched stent-grafts. METHODS: A consecutive series of 108 patients (mean age 73.5 years; 73 men) with TAAA were treated with E-xtra Design Engineering customized fenestrated-branched stent-grafts between November 2011 and January 2017. Data on baseline characteristics, procedures, and clinical follow-up were collected from 6 regional European surgical centers for retrospective analysis of endoleaks, reinterventions, and target vessel patency...
January 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29306627/favourable-outcomes-of-endovascular-total-aortic-arch-repair-via-needle-based-in-situ-fenestration-at-a-mean-follow-up-of-5-4%C3%A2-months
#5
Tao Shang, Lu Tian, Dong-Lin Li, Zi-Heng Wu, Hong-Kun Zhang
OBJECTIVES: Endovascular repair of aortic arch pathologies remains challenging. Recently, needle based in situ fenestration (ISF) has shown great potential in endovascular total aortic arch repair (ETAAR). This study aimed to evaluate the feasibility, effectiveness, and safety of ETAAR via needle based ISF, and to present initial experience with this technique. DESIGN AND METHODS: Patients who met the inclusion criteria were enrolled in this prospective study. The supra-arch branches were manually punctured in a retrograde manner using liver biopsy needles (18 gauge/30 cm) in the left common carotid artery (LCCA) and brachiocephalic trunk (BCT), and endo-puncture system or aspiration biopsy needles (21-gauge) in the left subclavian artery (LSA)...
January 3, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29246081/uncovered-chimney-stent-graft-for-renal-arteries-with-the-nellix-endovascular-aneurysm-sealing-technique
#6
Luca Garriboli, Antonio Maria Jannello
PURPOSE: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs). CASE REPORT: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29241685/fenestrated-thoracic-endovascular-aortic-repair-using-physician-modified-stent-grafts-for-acute-type-b-aortic-dissection-with-unfavourable-landing-zone
#7
Jiechang Zhu, Lujing Zhao, Xiangchen Dai, Yudong Luo, Hailun Fan, Zhou Feng, Yiwei Zhang, Fanguo Hu
OBJECTIVES: The aim was to evaluate the early results of fenestrated thoracic endovascular aortic repair (fTEVAR) using physician modified stent grafts (PMSGs) to revascularise aortic branches for acute type B aortic dissection (ABAD) with unfavourable proximal landing zone. METHODS: Twenty consecutive patients who underwent fenestrated TEVAR using PMSGs between November 2015 and December 2016 were retrospectively reviewed. Pre-, intra-, and post-operative clinical data were recorded...
December 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29235384/technique-for-fenestrated-stent-graft-implantation-as-a-proximal-extension-to-a-previous-fenestrated-endovascular-repair-for-abdominal-aortic-aneurysm
#8
Konstantinos Spanos, Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Christian-Alexander Behrendt, Eike Sebastian Debus, Tilo Kölbel
PURPOSE: To describe planning and a technique for fenestrated endovascular repair of a large Crawford type IV thoracoabdominal aortic aneurysm after previous 2-fenestration endovascular aneurysm repair (FEVAR). TECHNIQUE: The first FEVAR procedure performed at another center implanted a standard Zenith device with 2 fenestrations and 1 scallop for a juxtarenal abdominal aortic aneurysm. The diameter of the Crawford type IV thoracoabdominal aortic aneurysm had progressed from 68 to 75 mm within a year after the FEVAR...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29234731/endovascular-intimal-flap-septostomy-for-safe-landing-of-a-stent-graft-in-an-anastomotic-pseudoaneurysm-of-chronic-type-b-aortic-dissection
#9
Yoshiaki Saito, Kengo Tani, Satoshi Taniguchi, Ikuo Fukuda
Objective/Background: The purpose of this report is to demonstrate a novel endovascular technique for gaining and producing the maximal landing zone for a thoracic stent graft in a patient with a chronic type B aortic dissection. Methods: The patient was a 64 year old man with chronic type B aortic dissection. He had developed acute type B aortic dissection and undergone descending thoracic replacement (Zone 2-Th10) 12 years earlier. During follow-up, he developed an anastomotic false aneurysm distally...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29230497/triple-in-situ-antegrade-laser-fenestration-of-aortic-stent-graft-extension-using-fusion-imaging-for-urgent-treatment-of-symptomatic-abdominal-aneurysm-with-type-1-endoleak
#10
Joseph Touma, Hicham Kobeiter, Marek Majewski, Vania Tacher, Pascal Desgranges
The present report describes the management of massive proximal type 1 endoleak with an enlarged symptomatic aneurysmal sac. Urgent treatment was performed using in situ laser fenestration of an aortic proximal extension facing renovisceral ostia. Image fusion was obtained intraoperatively. For each target vessel (superior mesenteric and two renal arteries), an Aptus HeliFX steerable sheath (Medtronic) inserted through femoral access was curved to face the vessel's ostium marker. A laser catheter (Spectranetics) was used to traverse the stent-graft and insert a 0...
December 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29221957/endovascular-repair-of-complex-juxtarenal-aortic-aneurysm-using-a-combined-fenestrated-endograft-and-chimney-technique
#11
REVIEW
Zaher Fanari, Nilesh J Goswami
Chimney EVAR (CHEVAR) and Fenestrated EVAR (FEVAR) are two options for management of very complex abdominal aortic aneurysm (AAA). While some anatomical factors may favor one strategy over the other, there are some cases where the anatomical challenges may require using a hybrid approach. We are reporting the case of an 84-year-old male with a 6.8×5.7cm infrarenal abdominal aortic aneurysm that arises immediately below the level of the renal arteries and extends down to just above the iliac bifurcation with occluded celiac and inferior mesenteric arteries and severe bilateral renal artery stenosis with caudally oriented right renal and cranially oriented left renal artery...
November 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29187014/fenestrated-tevar-using-a-guidewire-fixator-for-anchoring-in-aortic-arch-target-vessels
#12
Tilo Kölbel, Linus Bosaeus, Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Krister Liungman
PURPOSE: To report a new facilitated method for securing target vessel access during single fenestrated and branched thoracic endovascular repair using a guidewire fixator. TECHNIQUE: The Liungman Guidewire Fixator (LGF) includes a 0.035-inch guidewire that is fitted with a stopper close to the distal end and a self-expanding anchoring element that is freely movable over the guidewire to the point of the stopper. The technique of using a LGF for anchoring in a target vessel is described in a 75-year-old woman with a 53-mm saccular arch aneurysm...
November 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29184616/hybrid-completion-of-aortic-repair-after-type-a-aortic-dissection-in-a-patient-with-marfan-s-syndrome
#13
Terri-Ann Teisha Russell, James Shue-Min Yeh, Antonios Kourliouros, Christoph A Nienaber
Medicine and engineering are in collaboration to assist in the tackling of daunting surgical techniques which are associated with high rates of morbidity and mortality, in exchange for minimally invasive approaches with lower procedural risk. Endovascular procedures in general have already reduced the risk of surgery by limiting the extent of open surgery and often replacing it with purely percutaneous or hybrid procedures. Here, we describe a patient who had complex staged surgery with open repair of a proximal portion of a type A aortic dissection followed by a staged endovascular reconstruction of the arch and descending aorta by means of a fenestrated stent-graft to secure the left subclavian artery and the posterior cerebral circulation...
July 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29161440/novel-arch-fenestrated-stent-graft-for-acute-stanford-type-a-aortic-dissection-with-open-antegrade-implantation
#14
Qing Zhou, Yunxing Xue, Hailong Cao, Jun Pan, Qiang Wang, Fudong Fan, Dongjin Wang
OBJECTIVES: The best surgical strategy for acute Stanford Type A aortic dissection (aTAAD) involving the arch remains controversial. Here, we report on the satisfactory results following aTAAD repair using a novel arch fenestrated stent graft. METHODS: From December 2014 to December 2015, 42 aTAAD patients (27 male and 15 female) underwent ascending aorta replacement and fenestrated stent graft implantation. The fenestrated stent graft was implanted into the true lumen of the aortic arch and proximal descending aorta, with the fenestration opening located at the ostia of 3 head vessels in the arch...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29078246/-surgeon-modified-stent-grafts-in-emergency-cases-as-addition-to-off-the-shelf-stent-grafts-for-complex-abdominal-and-thoracoabdominal-aortic-pathologies
#15
Franziska Heidemann, Tilo Kölbel, Sebastian Debus, Christian-Alexander Behrendt, Holger Diener, Fiona Rohlffs, Nikolaos Tsilimparis
Background Endovascular techniques have revolutionised the therapy of abdominal and thoracoabdominal aortic disease. For infrarenal abdominal aortic aneurysm, the endovascular aortic repair has become a standard for elective and emergent cases. In complex abdominal or thoracoabdominal aortic pathologies, involving reno-visceral vessels, there are technical challenges for open and endovascular surgery. Due to high mortality and morbidity of open surgery of complex aortic lesions, especially in emergent cases, endovascular techniques have developed as well...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28956729/the-use-of-thoracic-stent-grafts-for-endovascular-repair-of-abdominal-aortic-aneurysms
#16
V P Bastiaenen, Mgj Snoeijs, Jgam Blomjous, J Bosma, V J Leijdekkers, R C van Nieuwenhuizen, A C Vahl
Objectives Stent grafts for endovascular repair of infrarenal aneurysms are commercially available for aortic necks up to 32 mm in diameter. The aim of this study was to evaluate the feasibility of endovascular repair with large thoracic stent grafts in the infrarenal position to obtain adequate proximal seal in wider necks. Methods All patients who underwent endovascular aneurysm repair using thoracic stent grafts with diameters greater than 36 mm between 2012 and 2016 were included. Follow-up consisted of CT angiography after six weeks and annual duplex thereafter...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28939200/open-distal-fenestration-of-chronic-dissection-facilitates-endovascular-elephant-trunk-completion-late-outcomes
#17
Muhammad Aftab, Jay J Idrees, Frank Cikach, Jose L Navia, Donald Hammer, Eric E Roselli
BACKGROUND: Retrograde false lumen perfusion is a common mode of failure after stent grafting chronic aortic dissection. Open fenestration during the first-stage elephant trunk (ET) creates a landing zone for second-stage endovascular ET completion in patients with a false lumen aneurysm. Our objectives were to assess long-term safety and durability of this technique. METHODS: From 2007 to 2014, 56 patients with thoracoabdominal dissection and aneurysm underwent stage 1 ET and open fenestration...
September 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endograft
#18
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom-made scalloped/fenestrated stent grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28888759/impact-of-iliac-artery-anatomy-on-the-outcome-of-fenestrated-and-branched-endovascular-aortic-repair
#19
Enrico Gallitto, Mauro Gargiulo, Gianluca Faggioli, Rodolfo Pini, Chiara Mascoli, Antonio Freyrie, Stefano Ancetti, Andrea Stella
OBJECTIVE: Fenestrated and branched endovascular aneurysm repair (FB-EVAR) is a valid option to treat juxtarenal and pararenal abdominal aortic aneurysms and thoracoabdominal aortic aneurysms. Because successful deployment depends on complex maneuvers, hostile iliac artery anatomy (HIA) can prejudice the FB-EVAR outcome. The aim of the study was to evaluate the impact of HIA on FB-EVAR outcome. METHODS: Between 2010 and 2015, all patients undergoing FB-EVAR were prospectively categorized according to iliac anatomy (friendly iliac artery anatomy [FIA] or HIA)...
September 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28874089/outcome-of-surgeon-modified-fenestrated-branched-stent-grafts-for-symptomatic-complex-aortic-pathologies-or-contained-rupture
#20
Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Holger Diener, Sabine Wipper, E Sebastian Debus, Tilo Kölbel
PURPOSE: To analyze the outcome of surgeon-modified fenestrated and branched stent-grafts (sm-FBSG) in high-risk patients with symptomatic complex aortic pathology or contained rupture. METHODS: A single-center retrospective analysis was conducted of 21 consecutive patients (mean age 70 years, range 58-87; 16 men) treated with a sm-FBSG from April 2014 to September 2016. The indications included 11 thoracoabdominal and 10 pararenal aortic pathologies, which presented as symptomatic in 8 and as contained rupture in 13 patients...
September 1, 2017: Journal of Endovascular Therapy
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