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Fenestrated stent graft

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28867380/homemade-fenestrated-stent-graft-for-thoracic-endovascular-aortic-repair-of-zone-2-aortic-lesions
#7
Ludovic Canaud, Kiyofumi Morishita, Thomas Gandet, Julien Sfeir, Sebastien Bommart, Pierre Alric, Marcello Mandelli
OBJECTIVE: The aim of this retrospective analysis was to evaluate the outcomes of homemade fenestrated stent-grafts for thoracic endovascular aortic repair of zone 2 aortic lesions. METHODS: From November 2013 to January 2017, 24 patients underwent thoracic endovascular aortic repair with left subclavian artery revascularization using a homemade fenestrated stent-graft to preserve the patency of the left subclavian artery. Elective cases accounted for 54% (n = 13) of the sample...
August 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28836554/outcomes-of-chimney-and-or-periscope-techniques-in-the-endovascular-management-of-complex-aortic-pathologies
#8
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
https://www.readbyqxmd.com/read/28821949/electromagnetically-navigated-in-situ-fenestration-of-aortic-stent-grafts-pilot-animal-study-of-a-novel-fenestrated-evar-approach
#9
Tobias Penzkofer, Hong-Sik Na, Peter Isfort, Christoph Wilkmann, Sabine Osterhues, Andreas Besting, Christoph Hänisch, Stefan Bisplinghoff, Johannes Jansing, Sylvie von Werder, Jorge Gooding, Mathias de la Fuente, Andreas H Mahnken, Catherine Disselhorst-Klug, Thomas Schmitz-Rode, Christiane Kuhl, Philipp Bruners
PURPOSE: Assess electromagnetically guided in situ fenestration of juxtarenal aortic stent grafts in an in vivo model. METHODS: Using a newly developed electromagnetic guidance system together with a modified, electromagnetically guidable catheter with steerable tip, an electromagnetically trackable guidewire and a custom in situ fenestrateable stent graft, a series of seven animal experiments was performed. In a swine model, stent grafts were placed juxtarenally, covering the renal arteries...
August 18, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28795434/concomitant-antegrade-stent-grafting-of-the-descending-thoracic-aorta-during-transverse-hemiarch-reconstruction-for-acute-debakey-i-aortic-dissection-repair-improves-aortic-remodeling
#10
Ibrahim Sultan, Tyler J Wallen, Andreas Habertheuer, Mary Siki, George J Arnaoutakis, Joseph Bavaria, Wilson Y Szeto, Rita Milewski, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Concomitant endovascular stent grafting of the descending thoracic aorta during open repair for acute DeBakey I aortic dissection can be performed in patients with extensive dissection and malperfusion. We analyzed the effects of this strategy on distal aortic remodeling. METHODS: From 2006-2014, acute DeBakey I dissection patients without primary aortic arch tear undergoing open distal hemiarch reconstruction (Standard group) versus those undergoing hemiarch with descending thoracic aorta (DTA) thoracic endovascular aortic repair (TEVAR group) were retrospectively reviewed...
August 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28758547/design-of-a-sensorized-guiding-catheter-for-in-situ-laser-fenestration-of-endovascular-stent
#11
Roberta Piazza, Sara Condino, Aldo Alberti, Raffaella Nice Berchiolli, Gioachino Coppi, Marco Gesi, Vincenzo Ferrari, Mauro Ferrari
PURPOSE: The in situ fenestration of a standard endograft is currently limited by difficulties in targeting the fenestration site under fluoroscopic control and by the lack of a safe method to perforate the graft. Evidence in the literature suggests the use of a 3 D electromagnetic navigator to accurately guide the endovascular instruments to the target and a laser to selectively perforate the graft. The aim of this work is to provide design guidelines to develop a sensorized catheter to guide the laser tool to the fenestration site and conduct preliminary testing of the feasibility of the proposed solution...
December 2017: Computer Assisted Surgery (Abingdon, England)
https://www.readbyqxmd.com/read/28748863/in-vitro-stent-graft-fenestration-to-preserve-all-supra-aortic-branches-in-the-treatment-of-a-stanford-type-a-aortic-arch-dissection
#12
Tun Wang, Chang Shu, Ming Li, Alan Dardik, Quan-Ming Li
No abstract text is available yet for this article.
August 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28747079/endovascular-repair-of-a-thoracoabdominal-aortic-aneurysm-with-a-patient-specific-fenestrated-branched-stent-graft
#13
Bernardo C Mendes, Lawrence E Greiten, Gustavo S Oderich
PURPOSE: To describe the technical aspects of a thoracoabdominal aortic aneurysm (TAAA) repair using a patient-specific fenestrated-branched stent-graft. TECHNIQUE: The technique is demonstrated in a 69-year-old man with a 6.2-cm asymptomatic type III TAAA. A patient-specific fenestrated-branched stent-graft was designed with 2 down-going directional branches for the celiac and superior mesenteric arteries and 2 reinforced fenestrations for the renal arteries. The procedure was performed under general anesthesia and included sequential stenting of the celiac, superior mesenteric, and bilateral renal arteries...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28746064/precannulated-fenestrated-endovascular-aneurysm-repair-using-guidewire-fixator-a-novel-method-using-the-liungman-guidewire-fixator
#14
Linus Bosaeus, Kevin Mani, Anders Wanhainen, Krister Liungman
OBJECTIVE: By using a guidewire fixator, the distal guidewire position can be secured in an artery. This new principle enables a method for fenestrated endovascular aortic repair where the connection between the aortic branches and the stent graft fenestrations is made before inserting and deploying the stent graft. METHODS: This is conducted using a fenestrated stent graft with preloaded catheters, through which the prepositioned and distally secured guidewires from the branches are inserted...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28739468/back-table-surgeon-modification-of-a-t-branch
#15
Martin Scheerbaum, Tilo Kölbel, Fiona Rohlffs, Franziska Heidemann, Sebastian E Debus, Nikolaos Tsilimparis
BACKGROUND: Surgeon modification of commercially available aortic stent grafts represents a salvage option to treat complex aortic pathologies in high-risk patients. TECHNIQUE: A 68-year-old male was referred to our hospital with a contained rupture of the visceral aorta. The patient was previously treated with an infrarenal tube graft 16 years earlier as well as with a Crawford procedure with island patch of the celiac trunk (TC) and the superior mesenteric artery (SMA) and bypasses to both renal arteries 6 years before admission...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739454/parallel-grafts-used-in-combination-with-physician-modified-fenestrated-stent-grafts-for-complex-aortic-aneurysms-in-high-risk-patients-with-hostile-anatomies
#16
Joseph Touma, Dorian Verscheure, Marek Majewski, Pascal Desgranges, Frederic Cochennec
OBJECTIVE: To evaluate the feasibility and early outcomes of complex aortic aneurysm repair in high risk patients with hostile anatomies using both parallel stents and physician-modified stent-graft (PMSG) techniques to address the renovisceral arteries METHODS: Consecutive patients with complex suprarenal (SRA) and thoracoabdominal aortic aneurysms (TAAA) undergoing endovascular repair using combined parallel stents technique and PMSG between September 2013 and November 2015 were evaluated...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28690999/early-experiences-of-sandwich-technique-to-preserve-pelvic-circulation-during-endovascular-aneurysm-repair
#17
Daehwan Kim, Jung Kee Chung, Hyung Sub Park, In Mok Jung, Taeseung Lee
PURPOSE: To report experiences of the sandwich technique (ST) for preservation of pelvic flow during endovascular repair of complex aortic or aortoiliac aneurysms. MATERIALS AND METHODS: Eight patients underwent elective endovascular aneurysm repair (EVAR) using the ST between March 2013 and February 2017. The anatomic indications for the ST were complex aortoiliac aneurysms (5 cases), abdominal aortic aneurysms (AAA) with non-diseased short common iliac arteries (2 cases) and AAA with unilateral occluded iliac artery (1 case)...
June 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28685523/the-role-of-surgeon-modified-fenestrated-stent-grafts-in-the-treatment-of-aneurysms-involving-the-branched-visceral-aorta
#18
REVIEW
Benjamin J Pearce, Salvatore T Scali, Adam W Beck
Acceptance of endovascular technology has followed a predictable pattern in the treatment of aortic aneurysm disease. Initially, endovascular aneurysm repair (EVAR) was used to treat infrarenal abdominal aortic aneurysms (AAA) only in patients deemed medically unsuitable for open surgical repair (OSR). With improvement in device design, increased operative experience and favorable mortality benefits in randomized control trials, EVAR is now the preferred method for treatment of AAA worldwide. As the results with OSR are even worse as one ascends the aorta into the visceral segment and above, it stands to reason that EVAR technology to accommodate the aortic branches should have a similar adoption in treatment of proximal AAA and thoraco-abdominal aortic aneurysm (TAAA) disease...
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28668275/midterm-outcomes-and-evolution-of-gutter-area-after-endovascular-aneurysm-repair-with-the-chimney-graft-procedure
#19
Hector W L de Beaufort, Elena Cellitti, Quirina M B de Ruiter, Michele Conti, Santi Trimarchi, Frans L Moll, Constantijn E V B Hazenberg, Joost A van Herwaarden
OBJECTIVE: The objective of this study was to describe our experience with endovascular aneurysm repair (EVAR) with the use of chimney grafts for branch vessel preservation. METHODS: Patients treated with a chimney graft procedure between October 2009 and May 2015 were included for analysis. Patients who were not considered eligible for open surgical repair or for conventional, branched, or fenestrated endovascular repair were selected. A standardized operating procedure with left brachial or axillary artery cutdown access for the chimney grafts and bilateral femoral artery cutdown access for the aortic main device was used...
June 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#20
COMPARATIVE STUDY
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
November 2017: Journal of Vascular Surgery
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