Push-Up Technique and Anatomical Deployment With the Endurant Stent-Graft System for Severely Angulated Aneurysm Necks

2017 ◽  
Vol 24 (3) ◽  
pp. 435-439 ◽  
Author(s):  
Shizuyuki Dohi ◽  
Yasutaka Yokoyama ◽  
Taira Yamamoto ◽  
Kenji Kuwaki ◽  
Akifusa Hariya ◽  
...  
Keyword(s):  
Blood Flow ◽  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Stent Deployment ◽  
Proximal Neck ◽  
Aneurysm Repair ◽  
Angulated Neck ◽  
Stent Graft Implantation ◽  
Graft Implantation ◽  
Push Up

Purpose: To describe a technique suitable for treating severely angulated (>75°) necks during endovascular aneurysm repair using the Endurant stent-graft. Technique: In the push-up technique, the suprarenal stent is released early to fix the proximal stent-graft in place so that each stent in the neck can be deployed individually without displacing the device upward. It is important to push the delivery system up after each stent deployment to allow the fabric between the stents to fold up circumferentially. By doing so, there is minimal upward force applied to the suprarenal stent. Because the stents expand along the angulated neck while catching blood flow, this anatomical deployment is feasible, with hardly any change to the proximal neck shape after stent-graft implantation. Conclusion: The push-up technique and anatomical deployment with the Endurant stent-graft system are effective and safe methods for treating aneurysms with severely angulated necks.

scholarly journals Endovascular Aneurysm Sealing of a Collapsed and Thrombosed Aortic Stent-Graft With Renovisceral Chimney Stent-Grafts

2018 ◽  
Vol 26 (1) ◽  
pp. 72-75
Author(s):  
Fabien Lareyre ◽  
Claude Mialhe ◽  
Carine Dommerc ◽  
Juliette Raffort
Keyword(s):  
Stent Graft ◽  
Mesenteric Artery ◽  
Endovascular Aneurysm Repair ◽  
Stent Grafts ◽  
Aortic Thrombosis ◽  
Aortic Stent Graft ◽  
Aneurysm Repair ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-year-old man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.

scholarly journals Computational Fluid Dynamics Modeling of Redundant Stent-Graft Configurations in Endovascular Aneurysm Repair

2010 ◽  
Author(s):  
Leonard W. Tse ◽  
Tina L. T. Shek ◽  
Aydin Nabovati ◽  
Cristina H. Amon
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Blood Flow ◽  
Steady State ◽  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Clinical Consequence ◽  
Dynamics Modeling ◽  
Aneurysm Wall ◽  
Aneurysm Repair

An aneurysm is a bulge or localized dilation of an artery that can result in rupture, rapid blood loss, and death. Endovascular aneurysm repair (EVAR) is a minimally-invasive surgical technique that involves delivery of a stent-graft from within the blood vessels. The metallic stents anchor and support the graft (fabric tube), through which blood flow is contained and directed. This relieves the pressure on the weakened aneurysm wall. When the stent-graft is too long for a given patient, the redundant (extra) length adopts a convex configuration in the aneurysm. Based on clinical experience, we hypothesize that redundant stent-graft configurations increase the downward force acting on the device thereby increasing the risk of device dislodgement and failure. This work numerically studies both steady-state and physiologic pulsatile blood flow in redundant stent-graft configurations. Computational fluid dynamics simulations predicted peak downward displacement force for the zero-, moderate- and severe-redundancy configurations of 7.49, 7.65 and 8.04 N, respectively for steady-state flow; and 7.55, 7.70 and 8.31 N, respectively for physiologic pulsatile flow. These results suggest that redundant stent-graft configurations in EVAR do increase the downward force acting on the device, but the clinical consequence depends significantly on device-specific resistance to dislodgement.

Computational blood flow and vessel wall modeling in a CT-based thoracic aorta after stent-graft implantation

2010 ◽  
Author(s):  
Dilana Hazer ◽  
Markus Stoll ◽  
Eduard Schmidt ◽  
Goetz-M. Richter ◽  
Rüdiger Dillmann
Keyword(s):  
Blood Flow ◽  
Thoracic Aorta ◽  
Stent Graft ◽  
Vessel Wall ◽  
Stent Graft Implantation ◽  
Graft Implantation

scholarly journals Stent grafts implantation in patients with life-threatening aortic conditions – first experience in Kyrgyz Republic

2019 ◽  
Vol 3 (Issue 4) ◽  
pp. 208
Author(s):  
I.Z. Abdyldaev ◽  
S.D. Chevgun ◽  
M.A. Aripov ◽  
I.H. Bebezov ◽  
D. Ch. Cholponbaev ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
False Lumen ◽  
Kyrgyz Republic ◽  
Aortic Diseases ◽  
Stent Grafts ◽  
Life Threatening ◽  
Aortic Intima ◽  
Stent Graft Implantation ◽  
Graft Implantation

Objective: Aortic diseases remain an acute and debatable problem. Among all the aortic pathologies, the most dangerous are dynamic aneurysmal expansion, traumatic dissections and / or aneurysms, pure aortic intima dissections. Contemporary and less invasive treatment method is the stent graft implantation into aorta. This report describes the first experience of thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) in the Kyrgyz Republic in consecutive patients with life-threatening aortic conditions. Methods: Nine patients, who underwent TEVAR and EVAR, were presented after all clinical examinations, echocardiography and computed tomography angiography with various life-threatening aortic diseases. Among the pathologies there were 2 (22.2%) dissections only, traumatic aneurysm 1 (11.1%), aneurysm without dissection 1 (11.1%), aneurysm with intimal dissection 5 (55.6%). Seven patients with dissection had type B (The Stanford classification). Results: TEVAR was performed in eight cases EVAR just in one. All patients reached the 6-month endpoint.  None of the following, such as aneurysm expansion, aneurysm thrombosis or a functioning of false lumen at the sites of the stent graft implantation have been recorded. In addition, no further progression of the false lumen below the implantation zones was visualized. Mean diameter of stent grafts was 31.4 ± 4.8 mm and  188.9 ± 34.6 mm in length. Conclusion: This modest observation showed the effectiveness of stent grafts implantation procedures in various aortic life-threatening conditions, such as aneurysm and / or aortic intima dissection.

scholarly journals Oesophageal mucosal blood flow changes after thoracic endovascular stent graft implantation using a novel sensor probe†

2017 ◽  
Vol 26 (3) ◽  
pp. 487-493 ◽  
Author(s):  
Shintaro Katahira ◽  
Shunsuke Kawamoto ◽  
Naoki Masaki ◽  
Yukihiro Hayatsu ◽  
Tadao Matsunaga ◽  
...  
Keyword(s):  
Blood Flow ◽  
Stent Graft ◽  
Mucosal Blood Flow ◽  
Endovascular Stent ◽  
Endovascular Stent Graft ◽  
Flow Changes ◽  
Stent Graft Implantation ◽  
Sensor Probe ◽  
Graft Implantation

Complications after Endovascular Repair of Type B Aortic Dissection

2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Stent Grafting ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To outline the complications encountered after endoluminal treatment in patients with type B aortic dissection. Methods: Between 1999 and 2001, 14 patients (12 men; mean age 60.3 years, range 39–79) with isolated type B aortic dissection (13 chronic, 1 acute) underwent aortic stent-grafting. Three patients with chronic dissection presented an acute clinical picture and were managed emergently. The left subclavian artery was intentionally covered by the prosthesis in 9 patients. Follow-up studies were performed at 6-month intervals. Results: Stent-graft implantation was technically successful in all patients, but incomplete sealing (endoleak) of the entry site required additional proximal stent-graft implantation in 4. The left subclavian artery remained patent in 5 patients. Secondary conversion was required in 3 patients: 2 for acute type A dissection resulting from injury to the aortic arch by Talent endografts and a sustained hemorrhage (left hemothorax). In another patient, a secondary intramural hematoma subsided spontaneously. Anterior spinal artery syndrome in 1 patient persisted at 1 month. No bypass was necessary for the 9 patients with the covered left subclavian arteries. Mean follow-up was 14 months (range 1–23). Conclusions: Stent-grafting is feasible in patients with type B aortic dissection, although it is associated with a considerable rate of complications. Frank reporting of these sequelae for a variety of stent-grafts is of paramount importance to clarifying the limitations of the method.

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