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Fenestrated stent graft

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https://www.readbyqxmd.com/read/28690999/early-experiences-of-sandwich-technique-to-preserve-pelvic-circulation-during-endovascular-aneurysm-repair
#1
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
#2
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...
July 7, 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
#3
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
#4
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...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28621512/endovascular-redo-aortic-surgery
#5
Jacob Budtz-Lilly, Kiattisak Hongku, Björn Sonesson, Nuno Dias, Tim Resch
Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger AAA necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing...
June 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28619356/operative-and-one-year-outcomes-of-the-custom-made-fenestrated-anaconda%C3%A2-aortic-stent-graft-a-uk-multicentre-study
#6
Frances E Colgan, Peter M Bungay, Nicholas Burfitt, Andrew Hatrick, Michael J Clarke, Alun H Davies, Michael Jenkins, David Gerrard, John W Quarmby, Robin Williams
OBJECTIVES: Early and one year outcomes are presented for fenestrated endovascular aneurysm repair (FEVAR) of complex aortic aneurysmal disease with the custom-made Anaconda fenestrated stent graft in 101 patients. METHODS: Retrospective site-reported data from the first 101 elective cases (2010 to 2014) from four UK centres was studied to evaluate patient demographics, aneurysm morphology, clinical success and one year outcomes in patients undergoing fenestrated aneurysm repair with the custom-made Anaconda device...
June 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28597717/physician-modified-thoracic-stent-grafts-for-the-treatment-of-aortic-arch-lesions
#7
Ludovic Canaud, Toshio Baba, Thomas Gandet, Kouhei Narayama, Baris Ata Ozdemir, Tsuyoshi Shibata, Pierre Alric, Kiyofumi Morishita
PURPOSE: To evaluate outcomes of physician-modified thoracic stent-grafts for the treatment of aortic arch aneurysms. METHODS: A retrospective dual-center analysis was performed involving 36 patients (mean age 74.7±9 years, range 58-91; 27 men) with an aortic arch lesion who were treated between November 2013 and June 2016 using physician-modified thoracic stent-grafts. Half of the patients had a degenerative aneurysm; the remainder had type B dissection (n=9), traumatic transection (n=3), type Ia endoleak after previous endografting (n=5), or aortoesophageal fistula (n=1)...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28574051/-stagewise-hybrid-method-of-treating-a-patient-with-connective-tissue-dysplasia-aortic-aneurysm-and-distal-dissection
#8
É R Charchian, A A Skvortsov, D A Chakal, Z R Khachatrian
Presented herein is a clinical case report concerning the use of a hybrid technique in stagewise surgical management of a patient with distal dissection and an aneurysm of the thoracoabdominal portion of the aorta. The patient at high risk with the connective tissue dysplasia syndrome had a past medical history of prosthetic repair of the descending thoracic aorta with type-1 haemodynamic correction. Three years later, the findings of computed tomography demonstrated fenestration in the area of the distal anastomosis, a patent false channel, and an increase in the diameter of the unoperated thoracoabdominal portion of the aorta...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28559176/results-from-multiple-prospective-single-center-clinical-trials-of-the-off-the-shelf-p-branch-fenestrated-stent-graft
#9
Mark A Farber, Matthew J Eagleton, Tara M Mastracci, James F McKinsey, Raghuveer Vallabhaneni, Björn Sonesson, Nuno Dias, Timothy Resch
OBJECTIVE: The purpose of this study was to report prospective data of an off-the-shelf fenestrated endograft (Zenith p-Branch; Cook Medical, Bloomington, Ind) from four centers for the treatment of patients with pararenal abdominal aortic aneurysms. METHODS: Data were combined from four single-center investigational studies conducted in the United States and Europe. The p-Branch endograft consists of a proximal off-the-shelf component incorporating a scallop for the celiac artery, a superior mesenteric artery fenestration, and two conical pivot fenestrations to preserve flow to the renal vessels...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28559175/rescue-of-failed-endovascular-aortic-aneurysm-repair-using-the-fenestrated-anaconda-device
#10
Jürgen Falkensammer, Fadi Taher, Miriam Uhlmann, Kornelia Hirsch, Johannes Strassegger, Afshin Assadian
OBJECTIVE: Endovascular aortic aneurysm repair (EVAR) with a fenestrated device (FEVAR) allows an extension of the proximal sealing zone above the renal arteries to an adequate, healthier segment of the aorta. This feature makes FEVAR an option to treat patients with a diseased aortic neck or type Ia endoleak after EVAR. The aim of this investigation was to present a single-center experience with FEVAR for patients with an abdominal aortic endograft in situ compared with primary FEVAR...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#11
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28546044/endovascular-repair-of-thoraco-abdominal-and-arch-aneurysms-in-patients-with-connective-tissue-disease-using-branched-and-fenestrated-devices
#12
Rachel E Clough, Teresa Martin-Gonzalez, Katrien Van Calster, Adrien Hertault, Rafaëlle Spear, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
INTRODUCTION: Prophylactic open surgery is the standard practice in patients with connective tissue and thoraco-abdominal (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study was to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. METHODS: All patients with connective tissue disease that underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single high volume centre between 2004 and 2015 were included...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28514896/-snare-ride-a-bailout-technique-to-catheterize-target-vessels-with-unfriendly-anatomy-in-branched-endovascular-aortic-repair
#13
Marcelo Ferreira, Athanasios Katsargyris, Eduardo Rodrigues, Diego Ferreira, Rodrigo Cunha, Guilherme Bicalho, Gustavo Oderich, Eric L G Verhoeven
PURPOSE: To describe a novel endovascular bailout technique for successful completion of target vessel stenting during branched stent-graft repair of thoracoabdominal aortic aneurysms (TAAA) after encountering difficulties with standard catheterization techniques. TECHNIQUE: Technical difficulties when using fenestrated and branched grafts should be expected, especially in difficult anatomy or when an off-the-shelf device (eg, standard 4-branch device) is used that does not perfectly "match" the anatomy...
May 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28495541/endovascular-repair-of-a-short-neck-abdominal-aortic-aneurysm-with-a-physician-modified-vascutek-anaconda-stent-graft
#14
Ambroise Duprey, Sabrina Ben Ahmed, Antoine Millon, Patrick Feugier, Jean-Pierre Favre, Jean-Noël Albertini
An 81 year-old woman was referred for the treatment of a 79 mm-diameter short neck abdominal aortic aneurysm with highly tortuous iliac arteries. She was considered at high risk for open repair and not suitable for standard endovascular repair given the short length of the proximal neck. Delay for a manufactured custom-made fenestrated stent-graft was too long given the diameter of the aneurysm. A flexible stent-graft was preferred because of severe iliac tortuosity. Endovascular repair was performed using a physician-modified Anaconda stent-graft with one fenestration for the left renal artery...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28495540/results-of-the-french-multicentric-study-of-anaconda-tm-fenestrated-endografts-in-the-treatment-of-complex-aortic-pathologies-efefa-registry
#15
Dominique Midy, Jean-Pierre Becquemin, Claude Mialhe, Nicolas Frisch, Robert Martinez, Caroline Caradu
BACKGROUND: Most of the experience on fenestrated endovascular aneurysm repair (F-EVAR) involves the custom-made Zenith® endograft (Cook). The fenestrated Anaconda® endograft (Vascutek) was introduced with the potential advantages of complete repositioning and lack of stent material on the main aortic body for more versatility. However, few data are available. Our objective was to assess its mid-term results in the treatment of complex aortic aneurysms. METHODS: Consecutive patients treated with the custom-made Fenestrated Anaconda® Endograft in France and the Principality of Monaco, from December 2010 to October 2015, were included...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483632/chimney-technique-with-the-incraft%C3%A2-aaa-stent-graft-system-to-treat-pararenal-aortic-aneurysm-in-narrowed-iliac-axes
#16
Nunzio Montelione, Pasqualino Sirignano, Wassim Mansour, Martina Formiconi, Laura Capoccia, Francesco Speziale
To report a case of pararenal aortic aneurysm (PAAA) with narrowed iliac arteries treated by the chimney technique combined with the INCRAFT(®) AAA stent graft system. A 75-year-old man was diagnosed with a 55mm PAAA. Patient was judged unfit for open repair and for standard endovascular repair (EVAR) due to its clinical and anatomical requirements. Custom-made fenestrated device (FEVAR) was excluded due to the presence of narrowed and heavily calcified iliac axes. Consequently, patient underwent auspicious endovascular aneurysm repair with the INCRAFT(®) System and chimney grafts in the superior mesenteric artery and both renal arteries...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483620/clinical-outcomes-of-spinal-cord-ischemia-after-fenestrated-and-branched-endovascular-stent-grafting-during-total-endovascular-aortic-repair-for-thoracoabdominal-aortic-aneurysms
#17
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Hiroki Ohta, Soichirou Fukushima, Naoki Toya, Masayuki Hara
PURPOSE: In this single-center study, we assessed the clinical outcomes of fenestrated-endovascular aortic repair (f-EVAR) and branched EVAR on morbidity and mortality during total endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between July 2006 and June 2015, elective f-EVAR and multibranched EVAR (t-Branch) for TAAAs were performed in 99 patients at our institution [Crawford classification types I (7), II (13), III (6), IV (55), and V (18)]...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#18
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
#19
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
#20
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...
July 2017: British Journal of Surgery
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