Long-Term Experience of Endovascular Repair for Thoracic Aortic Aneurysms and Dissections

Endovascular graft (EVG) therapy has emerged as a promising alternative to open surgical repair of thoracic aortic aneurysms. However, the long-term durability of thoracic endovascular repair (TEVAR) remains uncertain due to complications such as incomplete aneurysm exclusion (endoleaks), migration, and stent fracture and collapse. These complications could likely be reduced if the biomechanical environment of the thoracic aorta was better understood. Currently, there are three FDA approved EVGs for treatment of descending thoracic aortic aneurysms (DTAA), but the range of bench-top testing mechanisms for these devices are limited.

Download Full-text

Stents for the Treatment of Aortic Aneurysms

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615578 ◽

1999 ◽

Vol 82 (S 01) ◽

pp. 171-175 ◽

Cited By ~ 1

Author(s):

D. Ebert ◽

M. Langer ◽

P. Uhrmeister

Keyword(s):

Endovascular Treatment ◽

Endovascular Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Imaging Modalities ◽

Exclusion Criteria ◽

Multicenter Studies ◽

Abdominal Aortic ◽

First Results

SummaryThe endovascular treatment of abdominal aortic aneurysms has generated a great deal of interest since the early 1990s, and many different devices are currently available. The procedure of endovascular repair has been evaluated in many institutions and the different devices are compared. The first results were encouraging, but complications like endoleak, dislocation or thrombosis of the graft occurred. By the available devices the stent application is only promising, if the known exclusion criteria are strictly respected. Therefore a careful preinterventional assessment of the patient by different imaging modalities is necessary. As the available results up to now are preliminary and the durability of the devices has to be controlled, multicenter studies are required to improve the devices and observe their long- term success in the exclusion of abdominal aortic aneurysms.

Download Full-text

Factors Affecting Long-term Mortality After Endovascular Repair of Abdominal Aortic Aneurysms

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70754-1 ◽

2008 ◽

Vol 2008 ◽

pp. 142-143

Author(s):

G.L. Moneta

Keyword(s):

Endovascular Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Factors Affecting ◽

Abdominal Aortic ◽

Long Term Mortality

Download Full-text

The first commercial use of the Valiant Navion stent graft system for endovascular repair of a descending thoracic aortic aneurysm

Vascular ◽

10.1177/1708538120981127 ◽

2020 ◽

pp. 170853812098112

Author(s):

Cassra N Arbabi ◽

Navyash Gupta ◽

Ali Azizzadeh

Keyword(s):

Stent Graft ◽

Standard Of Care ◽

Aortic Aneurysms ◽

Descending Thoracic Aortic Aneurysm ◽

Thoracic Aortic Aneurysms ◽

Commercial Use ◽

Early Results ◽

Multiple Configuration ◽

One Year

Objectives Thoracic endovascular aortic repair (TEVAR) is the standard of care for descending thoracic aortic aneurysms (DTAA), and newer generation stent grafts have significant design improvements compared to earlier generation devices. Methods We report the first commercial use of the Medtronic Valiant Navion stent graft for treatment of an 85-year-old woman with a 5.8 cm DTAA and a highly tortuous thoracic aorta. Results A percutaneous TEVAR was performed using a two-piece combination of the Valiant Navion FreeFlo and CoveredSeal stent graft configurations for zones 2–5 coverage. The devices were successfully delievered through highly tortuous anatomy and deployed, excluding the entire length of the aneurysm with precise landing, excellent apposition and no evidence of endoleak. The patient tolerated the procedure well and has had no stent graft-related complications through one-year follow-up. Conclusions Design enhancements such as a lower profile delivery system, better conformability, and a shorter tapered tip are some of the improvements to this third-generation TEVAR device. Coupled with the multiple configuration options available, this gives physicians a better tool to treat thoracic aortic pathologies in patients with challenging anatomy. The early results are encouraging, and evaluation of long-term outcomes will continue.

Download Full-text