scholarly journals Use of Bare Dissection Stents With Covered Stent Grafts Promotes Greater False Lumen Thrombosis and Aortic Remodeling Compared With Covered Stents Alone in All TBAD

2021 ◽  
Vol 74 (3) ◽  
pp. e225
Author(s):  
Michael J. Wilderman ◽  
David O'Connor ◽  
Anjali Ratnathicam ◽  
Kristen Cook ◽  
Massimo Napolitano ◽  
...  
Keyword(s):  
False Lumen ◽  
Covered Stent ◽  
Covered Stents ◽  
Stent Grafts ◽  
Aortic Remodeling

Covered stents in transjugular portosystemic shunt: healing response to non-porous ePTFE covered stent grafts with and without intraluminal irradiation

2002 ◽  
Vol 13 (7) ◽  
pp. 1549-1558 ◽  
Author(s):  
Klaus A. Hausegger ◽  
Horst Portugaller ◽  
Nicolas P. Macri ◽  
Josef Tauss ◽  
Peter Schedlbauer ◽  
...  
Keyword(s):  
Covered Stent ◽  
Portosystemic Shunt ◽  
Covered Stents ◽  
Stent Grafts ◽  
Healing Response ◽  
Transjugular Portosystemic Shunt

Elective placement of covered stents in native coronary arteries

2003 ◽  
Vol 44 (3) ◽  
pp. 294-301 ◽  
Author(s):  
E. Søvik ◽  
N-E. Kløw ◽  
M. Brekke ◽  
S. Stavnes
Keyword(s):  
Stent Graft ◽  
Coronary Arteries ◽  
Nyha Class ◽  
Covered Stent ◽  
Covered Stents ◽  
Restenosis Rate ◽  
Stent Grafts ◽  
Target Vessel Revascularization ◽  
Q Wave

Purpose: To study the feasibility of placing a polytetrafluoroethylene (PTFE)-covered stent graft into native coronary arteries and assess the complications and the restenosis rate. Material and Methods: Fifty consecutive patients with stable angina pectoris were included and the stent graft was placed into native coronary arteries. Clinical and angiographic follow-up were performed after 6 months. Results: The stent grafts were successfully placed in all patients. The mean reference diameter was 3.3 ± 0.6 mm. During follow-up the stent grafts occluded in patients after 1, 2 and 2.5 months and one more was occluded at 6 months. Three patients experienced myocardial infarction, 2 Q wave and one non-Q wave. After 6 months 42 (84%) patients had angina NYHA class 0 or 1. Target vessel revascularization was done in 11 cases for restenosis in the graft (n = 4), outside the graft (n = 3) and both (n = 4), giving a restenosis rate of 24%. The total major adverse coronary events at 6 months was 24%. Conclusion: The stent graft was deployed with a high success rate. The restenosis rate was not higher than expected for bare stents. However, this study showed that subacute occlusion may occur more frequently and we therefore recommend that ticlopidine or clopidogrel treatment should be prolonged to at least 3 months.

Transbrachial and transfemoral approaches combined with visceral protection for the treatment of juxtarenal aortoiliac occlusive disease: Technical issues and clinical outcomes

Vascular ◽  
2021 ◽  
pp. 170853812110232
Author(s):  
Peixian Gao ◽  
Changliang Li ◽  
Xuejun Wu ◽  
Gang Li ◽  
Dianning Dong ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Bare Metal Stents ◽  
Covered Stent ◽  
Occlusive Disease ◽  
Metal Stents ◽  
Infrarenal Aorta ◽  
Bare Metal ◽  
Stent Grafts ◽  
Aortoiliac Occlusive Disease

Purpose To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period. Methods In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. The indications for treatment were critical limb threatening ischemia in 12 patients and bilateral claudication in five patients. Percutaneous access via the left brachial artery was first obtained to recanalize the infrarenal occluded lesions. After that, femoral accesses were achieved. A 4-Fr catheter, a 4 mm balloon, or a 6-Fr 90-cm-long sheath was used to complete visceral artery protection. Results A total of 17 juxtarenal AIOD patients (14 males; mean age, 63.4 ± 8.1 years) underwent endovascular treatment. The technical success rate was 100%. Complete reconstruction was achieved in 15 (88.2%) patients. The infrarenal aorta was reconstructed with kissing covered stent grafts ( n = 7), kissing bare-metal stents ( n = 2), covered stent grafts ( n = 2), bare-metal stents ( n = 1), or the off-label use of iliac limb stent grafts ( n = 5). Renal embolization was found in 3 (17.6%) patients during intraoperative angiography. There was 1 (5.9%) case of distal runoff embolization after CDT and 1 (5.9%) case of left iliac artery rupture. One (5.9%) death occurred due to acute myocardial infarction 20 days after the operation. The average follow-up period was 19.3 ± 16.7 months (range, 1–54 months) in the remaining 16 cases. The renal artery patency rate was 100%. The estimated cumulative primary patency rates were 92.3% at 12 months and 59.3% at 36 months according to the Kaplan–Meier method. Conclusions Transbrachial and transfemoral approaches combined with visceral protection offer a safe and effective alternative to open revascularization for the endovascular treatment of juxtarenal AIOD.

Aortic Remodeling After Custom-Made Candy-Plug for Distal False Lumen Occlusion in Aortic Dissection

2021 ◽  
pp. 152660282199672
Author(s):  
Ahmed Eleshra ◽  
Fiona Rohlffs ◽  
Konstantinos Spanos ◽  
Giuseppe Panuccio ◽  
Franziska Heidemann ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Success ◽  
False Lumen ◽  
High Rate ◽  
Single Center ◽  
Original Design ◽  
Mortality And Morbidity ◽  
Custom Made ◽  
Aortic Remodeling

Purpose: To report a single-center experience with the use of a custom-made Candy-Plug (CP) for distal false-lumen (FL) occlusion in subacute and chronic aortic dissection (AD). Materials and Methods: A retrospective single-center analysis was conducted on consecutive patients with subacute and chronic AD who were treated with a custom-made CP for distal FL occlusion using 3 design generations (CP I to CP III) from October 2013 to September 2019. Results: A custom-made CP was used in 57 patients. Of these, 34 patients (29 males, mean age 62±10 years) were treated with a CP I vs 23 patients (16 males, mean age 59±17 years) with CP II/III. Technical success was achieved in 57 (100%) patients. Clinical success was achieved in 54 (95%) patients; 33 (97%) in CP I group vs 21 (91%) patients in CP II/III group, p=0.116. The mean hospital stay was 10±8 days (9±5 days in CP I group vs 13±9 days in CP II/III, p=0.102). The 30-day computed tomography angiography (CTA) confirmed successful CP placement at the intended level in all patients within both groups. Early complete FL occlusion was achieved in 50 (88%) patients; 30 (88%) patients in CP I group vs 20 (87%) in CP II/III group, p=0.894. Follow up CTA was available in 44 (77%) patients. Of these; 30/34 (88%) patients in CP I group with mean follow-up 29±17 months) vs. 14/23 (61%) patients with mean follow-up 14±5 months in CP II/III group. Thoracic aortic remodeling was achieved in 34/44 (77%) patients; 25/30 (83%) patients in CP I group vs 9/14 (64%) patients in CP II/III group, p=0.197. The aneurysm size remained stable in 9/44 (20%) patients; 5/30 (17%) patients in CP I group vs 4/14 (29%) patients in CP II/III group, p=0.741. The thoracic aneurysm increased size was seen in 1/44 (2%) patient. This patient was in CPII/III group. Conclusion: CP technique using custom-made devices is technically feasible with a low mortality and morbidity, and a high rate of aortic remodeling. Both, the original design (CP I) and newer designs with a self-closing central sleeve (CP II and CP III) showed similar excellent outcomes.

scholarly journals ‘Pave-and-crack’ technique for the recanalization of severely calcified occlusive aorto-ilio-femoral disease in type-III Leriche syndrome: a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Sorin Giusca ◽  
Andrej Schmidt ◽  
Grigorios Korosoglou
Keyword(s):  
External Iliac Artery ◽  
Covered Stent ◽  
Radial Force ◽  
Covered Stents ◽  
Leriche Syndrome ◽  
Step Procedure ◽  
Technical Advances ◽  
Radial Forces ◽  
Endovascular Approach ◽  
The Right

Abstract Background  Leriche syndrome is the result of the atherosclerotic occlusion of the distal aorta that may also involve pelvic arteries. The standard treatment for this condition is considered surgical with various techniques available for establishing appropriate flow to both limbs. However, due to the technical advances in the last decades, endovascular approaches are now also capable to tackle such lesions. The ‘pave-and-crack’ technique enables the treatment of severely calcified lesions. This two-step procedure consists of firstly placing a covered stent prothesis (VIABAHN) into the severely calcified segment, which is afterwards aggressively dilated with high-pressure balloons. Subsequently, an interwoven nitinol SUPERA stent with high radial forces is placed within the prothesis. Case summary  Herein, we describe the case of an 81-year-old male patient, who presented with critical limb-threatening ischaemia of his right leg. Doppler ultrasound revealed a long occlusion of the right external iliac artery, common femoral, superficial femoral, and deep femoral artery. The lesion was successfully tackled using antegrade and retrograde punctures and the ‘pave-and-crack’ technique. Discussion  The ‘pave-and-crack’ technique is an endovascular approach for the treatment of severe circumferential calcified lesions. Based on this technique covered stents are initially placed to prevent vessel rupture, which might occur during the aggressive balloon dilatation. Subsequently, the covered stents are relined by interwoven Supera stents, which provide high radial force preventing recoil and restenosis.

Abstract 1122‐000097: Recurrent Carotid Cavernous Fistula Requiring Complex Repair of Ruptured Cavernous Carotid Aneurysm: A Case Report

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Rami Z. Morsi ◽  
Faten El Ammar ◽  
Sonam Thind ◽  
Scott J. Mendelson ◽  
Cedric McKoy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Large Scale ◽  
Mechanical Valve ◽  
Covered Stent ◽  
Stent Grafts ◽  
Cerebral Angiogram ◽  
Safety And Efficacy ◽  
Third Nerve Palsy ◽  
History Of

Introduction : There are no studies investigating the safety and efficacy of covered stent grafts, particularly the newly developed stents such as the PK Papyrus stent, for endovascular treatment of direct carotid cavernous fistulas (CCFs). Methods : We present a case of a 75‐year‐old female who presented to the hospital with a three‐week history of worsening left eye vision, chemosis, proptosis, and partial third nerve palsy. Patient was found to have left direct Type A CCF secondary to ruptured cavernous segment carotid aneurysm. Results : The CCF was treated with coil embolization and pipeline Shield stent embolization devices with immediate stagnation and improvement of symptoms. Patient had history of an aortic mechanical valve and thus was started on warfarin and ASA. After achieving INR level of 2.5‐3.5, patient started to have recurrent swelling of the left eye associated and decreased visual acuity. Repeated diagnostic cerebral angiogram revealed residual CCF. Onyx liquid embolization and a Surpass Evolve Flow Diverter were attempted to slow the fistulization with no success. Multiple attempts for direct percutaneous superior ophthalmic vein cannulation were also unsuccessful. At this point, two coronary graft‐covered PK Papyrus stents were implanted across the fistula pouch, which resulted in immediate resolution of the CCF with evidence of persistent normal flow within left ophthalmic artery. Patient’s visual acuity and left eye movement improved. Conclusions : This case report highlights the effectiveness and safety of covered stent grafts, particularly more flexible stents such as the PK Papyrus stent, in navigating the carotid vasculature and closing direct CCFs and may be used as a first‐line technique. More large‐scale studies are warranted to investigate the safety and efficacy of using such stent grafts to treat direct CCFs in the setting of antithrombotic agents and anticoagulation.

Candy-Plug Generation II for False Lumen Occlusion in Chronic Aortic Dissection: Feasibility and Early Results

2019 ◽  
Vol 26 (6) ◽  
pp. 782-786 ◽  
Author(s):  
Ahmed Eleshra ◽  
Tilo Kölbel ◽  
Nikolaos Tsilimparis ◽  
Giuseppe Panuccio ◽  
Martin Scheerbaum ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Success ◽  
False Lumen ◽  
The Other ◽  
Type I ◽  
Technical Success ◽  
Chronic Aortic Dissection ◽  
Early Results ◽  
Aortic Remodeling

Purpose: To present the early results of false lumen (FL) occlusion in chronic aortic dissection using the Candy-Plug generation II (CP II), which has a self-closing fabric channel that obviates the need for separate occlusion of its center. Materials and Methods: Fourteen consecutive patients (mean age 60±11 years; 10 men) with persistent FL backflow and aneurysm formation at the thoracic segment in chronic aortic dissection underwent thoracic endovascular aortic repair (TEVAR) with FL occlusion using the refined CP II. Primary endpoints were technical success (successful deployment) and clinical success (no FL backflow at the CP II level). Secondary endpoints included 30-day mortality and morbidity and aortic remodeling during follow-up. Results: Technical success was 100%. One patient required additional intraprocedural FL embolization at the CP II level due to persistent FL backflow on final angiography (clinical success 93%), though there was no flow through the CP II center. There were no intraprocedural complications. Immediate complete FL occlusion was achieved in 12 patients; the other 2 required reintervention. One had contrast enhancement in the distal FL proximal to the CP II and was treated with coil embolization. The other patient had persistent type I endoleak at the level of the left subclavian artery (LSA) and underwent left carotid–LSA bypass and proximal stent-graft extension. One patient died due to retrograde type A aortic dissection that was not related to CP II placement. Over a mean 8-month follow-up (range 3–12), 9 patients had computed tomography angiography; 8 patients had evidence of aortic remodeling, while 1 aneurysm sac was stable. Conclusion: The CP II reduces the number of procedural steps and offers good seal, with minimal morbidity and mortality and a high rate of aortic remodeling.

Sign in / Sign up

Export Citation Format

Share Document