scholarly journals Aortic arch banding procedure for proximal type I endoleak after thoracic endovascular aneurysm repair with the chimney technique

2017 ◽  
Vol 3 (4) ◽  
pp. 228-231
Author(s):  
Genta Chikazawa ◽  
Arudo Hiraoka ◽  
Koichi Inoue ◽  
Kentaro Tamura ◽  
Taichi Sakaguchi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Endovascular Aneurysm Repair ◽  
Type I ◽  
Chimney Technique ◽  
Type I Endoleak ◽  
Thoracic Endovascular Aneurysm Repair ◽  
Aneurysm Repair

scholarly journals Type I Endoleak Post-Endovascular Aneurysm Repair, Successfully Treated With Excluder Cuff and Fixation Screws

2018 ◽  
Vol 11 (1) ◽  
pp. e5-e6 ◽  
Author(s):  
Omar A. Ayah ◽  
Jordan Klein ◽  
Muhammad Raza ◽  
Daniel J. McCormick
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Type I ◽  
Type I Endoleak ◽  
Aneurysm Repair

Initial Clinical Experience Using the Low-Profile Altura Endograft System With Double D-Shaped Proximal Stents for Endovascular Aneurysm Repair

2018 ◽  
Vol 25 (3) ◽  
pp. 379-386 ◽  
Author(s):  
Dainis Krievins ◽  
Albrecht Krämer ◽  
Janis Savlovskis ◽  
Georgij Oszkinis ◽  
E. Sebastian Debus ◽  
...  
Keyword(s):  
Clinical Investigation ◽  
Clinical Success ◽  
Endovascular Aneurysm Repair ◽  
Clinical Results ◽  
Type I ◽  
Midterm Outcome ◽  
Early Results ◽  
Low Profile ◽  
Type I Endoleak ◽  
Aneurysm Repair

Purpose: To report the initial clinical results of endovascular aneurysm repair (EVAR) using the low-profile (14-F) Altura Endograft System, which features a double “D-shaped” stent design with suprarenal fixation and modular iliac components that are deployed from distal to proximal. Methods: From 2011 to 2015, 90 patients (mean age 72.8±8.3 years; 79 men) with abdominal aortic aneurysm (AAA; mean diameter 53.8±5.7 mm) were treated at 10 clinical sites in 2 prospective, controlled clinical studies using the Altura endograft. Outcomes evaluated included mortality, major adverse events (MAEs: all-cause death, stroke, paraplegia, myocardial infarction, respiratory failure, bowel ischemia, and blood loss ≥1000 mL), and clinical success (freedom from procedure-related death, type I/III endoleak, migration, thrombosis, and reintervention). Results: Endografts were successfully implanted in 89 (99%) patients; the single failure was due to delivery system malfunction before insertion in the early-generation device. One (1%) patient died and 4 patients underwent reinterventions (1 type I endoleak, 2 iliac limb stenoses, and 1 endograft occlusion) within the first 30 days. During a median follow-up of 12.5 months (range 11.5–50.9), there were no aneurysm ruptures, surgical conversions, or AAA-related deaths. The cumulative MAE rates were 3% (3/89) at 6 months and 7% (6/89) at 1 year. Two patients underwent coil embolization of type II endoleaks at 6.5 months and 2.2 years, respectively. Clinical success was 94% (84/89) at 30 days, 98% (85/87) at 6 months, and 99% (82/83) at 1 year. Conclusion: Early results suggest that properly selected AAA patients can be safely treated using the Altura Endograft System with favorable midterm outcome. Thus, further clinical investigation is warranted to evaluate the role of this device in the treatment of AAA.

Type IIIb Endoleak After Endovascular Aneurysm Repair Using the Zenith Stent Graft

2019 ◽  
Vol 53 (6) ◽  
pp. 515-519
Author(s):  
Toshiya Nishibe ◽  
Toru Iwahashi ◽  
Kentaro Kamiya ◽  
Masaki Kano ◽  
Keita Maruno ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aneurysm Rupture ◽  
Type I ◽  
Stent Grafts ◽  
System Type ◽  
Type Iiib ◽  
Type I Endoleak ◽  
Aneurysm Repair

We present 3 cases of type IIIb endoleak after endovascular aneurysm repair (EVAR) using the Zenith stent graft system. Type III endoleak, like type I endoleak, is a high-pressure, high-risk leak that increases sac pressure up to or even above arterial pressure, and is associated with an increased frequency of open conversions or risk of aneurysm rupture. Type IIIb endoleak is rare but there is much concern that the incidence of type IIIb endoleak is likely to increase hereafter; the mechanism of type IIIb endoleak is deterioration of graft fabric in conjunction with stent sutures. Type IIIb endoleak is difficult to diagnose before rupture. The possibility of type IIIb endoleak should be highly suspected when the continued growth of an excluded aneurysm sac without direct radiologic evidence is observed during follow-up. Type IIIb endoleak can be repaired by relining of the stent graft with additional stent grafts.

Aortic arch stenting: current strategies, new technologies and future directions

Heart ◽  
2021 ◽  
pp. heartjnl-2020-317732
Author(s):  
Arjune S Dhanekula ◽  
Matthew P Sweet ◽  
Nimesh Desai ◽  
Christopher R Burke
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
New Technologies ◽  
Endovascular Aneurysm Repair ◽  
Future Directions ◽  
Operative Morbidity ◽  
Formidable Challenge ◽  
Thoracic Endovascular Aneurysm Repair ◽  
Aneurysm Repair ◽  
Remarkable Reduction

Operating on the aortic arch is a formidable challenge. Open operations remain the gold standard, but despite improvement in technique and outcomes, they are still associated with significant morbidity and mortality. The last 20 years have seen a remarkable reduction in the operative morbidity associated with treatment of the descending thoracic aorta using thoracic endovascular aneurysm repair (TEVAR). To improve outcomes following arch repair, new TEVAR devices, including both single-branched and multibranched designs, have come to clinical trial. This review discusses the modern state of open and hybrid repairs while introducing the reader to technology for endovascular therapy of the aortic arch. We describe important anatomical and operative considerations for the devices. Given these nuances, we believe the future of the aortic arch to be patient-individualised hybrid repairs, involving both open and endovascular options with a multidisciplinary ‘thoracic aorta team’ at the helm.

scholarly journals Safety of EndoAnchors in real-world use: A report from the Manufacturer and User Facility Device Experience database

Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 495-499 ◽  
Author(s):  
Reza Masoomi ◽  
Emily Lancaster ◽  
Alexander Robinson ◽  
Ethan Hacker ◽  
Zvonimir Krajcer ◽  
...  
Keyword(s):  
Adverse Events ◽  
Real World ◽  
Endovascular Aneurysm Repair ◽  
The United States ◽  
Type I ◽  
Fda Approval ◽  
User Facility ◽  
The Usa ◽  
Type I Endoleak ◽  
Aneurysm Repair

Objectives A hostile proximal neck anatomy is the most common cause of abdominal aorta endovascular aneurysm repair failure leading to a higher risk of device migration, proximal type I endoleak, and subsequent open surgical repair. Endostapling is a technique to attain better fixation of the endograft to the aortic wall, and the only available device in the USA is Aptus Heli-FX EndoAnchor system (Medtronic Vascular, Santa Rosa, CA, USA). Preliminary data have shown efficacy and safety of its use, and the aim of this study is to assess device-related adverse events in real-world clinical use. Methods We quarried data from the publicly available Manufacturer and User Facility Device Experience database to identify Aptus Heli-FX EndoAnchor system-related adverse reports in endovascular aneurysm repair since FDA approval till August 31, 2017. An estimate of total devices implanted in the United States was quoted around 7,000 (Medtronic marketing internal data). Results Our query identified 229 separate reports, of which there were 85 adverse events (1.2% of the estimated EndoAnchor systems used). The most common adverse events were device dislodgement/fracture (65) and applicator malfunction (20). Conclusion In early post-FDA approval use in a real-world setting, the EndoAnchor system is associated with a low rate of adverse events. Device dislodgement and embolization remain the most common adverse events. With increasing use of these devices in more difficult anatomy, careful patient selection and careful attention to technique may help to reduce these events even further.

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