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CASE REPORTS
JOURNAL ARTICLE
The Cuff Plus Anchoring Funnel Technique for Endovascular Aortic Repair (CAF-EVAR) for Large Infrarenal Necks.
Cardiovascular and Interventional Radiology 2018 Februrary
PURPOSE: To present a case of a patient with possible short (2 years approximately) life expectancy and a 68-mm abdominal aortic aneurysm with a large infrarenal neck and large suprarenal aorta that precluded chimney endovascular aortic repair (Ch-EVAR) treatment.
MATERIALS AND METHODS: The technical aspects of a modification of the funnel technique (thoracic endograft as a proximal extension of a main infrarenal device in wide necks) are described. We advocated a migrated bifurcated 36-mm endograft in a 34-mm native aorta, ten mm below the lowest renal artery and added endoanchor (four) fixation to this "intentionally migrated main endograft." Afterward, we extended proximally a large aortic 38-mm-wide/50-mm-long cuff using the remaining 10-mm neck for cuff sealing. This aortic cuff achieved 8.5% oversizing in this 10-mm neck length. We again added additional endoanchoring (four) on this cuff.
RESULTS AND CONCLUSIONS: Insights into technical issues for this bailout technique are described. No proximal endoleak or sac enlargement or migration is founded on 6-month follow up.
MATERIALS AND METHODS: The technical aspects of a modification of the funnel technique (thoracic endograft as a proximal extension of a main infrarenal device in wide necks) are described. We advocated a migrated bifurcated 36-mm endograft in a 34-mm native aorta, ten mm below the lowest renal artery and added endoanchor (four) fixation to this "intentionally migrated main endograft." Afterward, we extended proximally a large aortic 38-mm-wide/50-mm-long cuff using the remaining 10-mm neck for cuff sealing. This aortic cuff achieved 8.5% oversizing in this 10-mm neck length. We again added additional endoanchoring (four) on this cuff.
RESULTS AND CONCLUSIONS: Insights into technical issues for this bailout technique are described. No proximal endoleak or sac enlargement or migration is founded on 6-month follow up.
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