scholarly journals Hybrid One-Stage Repair Using a Sutureless Telescoped Stent Graft Fixation for Ruptured Multiple Thoracic Aortic Aneurysms

2014 ◽  
Vol 20 (Supplement) ◽  
pp. 918-921 ◽  
Author(s):  
Keiji Kamohara ◽  
Atsuhisa Tanaka ◽  
Manabu Itoh ◽  
Hiroyuki Morokuma ◽  
Kojiro Furukawa ◽  
...  
2002 ◽  
Vol 16 (1) ◽  
pp. 24-28 ◽  
Author(s):  
James A. Burks ◽  
Peter L. Faries ◽  
Edwin C. Gravereaux ◽  
Larry H. Hollier ◽  
Michael L. Marin

Vascular ◽  
2020 ◽  
pp. 170853812098112
Author(s):  
Cassra N Arbabi ◽  
Navyash Gupta ◽  
Ali Azizzadeh

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.


1997 ◽  
Vol 2 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Charles P Semba ◽  
R Scott Mitchell ◽  
D Craig Miller ◽  
Noriyuki Kato ◽  
Stephen T Kee ◽  
...  

The purpose of the study was to describe the clinical experience in using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22–24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35-month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long-term studies are needed to determine protection against aneurysm rupture and patient survival.


Author(s):  
Rachel Rolph ◽  
James MN Duffy ◽  
Bijan Modarai ◽  
Rachel E Clough ◽  
Peter Taylor ◽  
...  

2003 ◽  
Vol 10 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Junichiro Sanada ◽  
Osamu Matsui ◽  
Noboru Terayama ◽  
Satoshi Kobayashi ◽  
Tetsuya Minami ◽  
...  

Purpose: To evaluate the clinical efficacy of a curved nitinol stent-graft for repair of thoracic aortic aneurysms. Methods: The Matsui-Kitamura stent-graft (MKSG), composed of a self-expanding nitinol stent and polyester fabric, was shaped to match the aortic curvature of 11 patients (6 men; mean age 72.6 years, range 33–90) with 6 true and 5 false aneurysms of the distal arch or proximal descending aorta. The delivery system was an 18 or 20-F J-shaped sheath combined with a preloader-type introducer. The original mean proximal neck length was 16.4 mm, but 4 patients received an axilloaxillary bypass to lengthen the neck. Although the mean corrected proximal neck length was 21.9 mm (overall), 5 cases still had proximal necks <15 mm long. Results: All curved MKSGs were successfully deployed in the correct position and fitted to the curvature of the aortic arch, achieving complete aneurysm exclusion in 8 (73%) cases. The other 3 repairs displayed early endoleaks; 1 received an additional MKSG, but the other 2 are being observed. Thirty-day mortality was 0%. One patient developed transient renal failure requiring hemodialysis; no neurological complications were observed. Conclusions: Endovascular repair of thoracic aortic aneurysms using curved MKSGs appears to be feasible and clinically effective. A tighter fit of the device to the curvature of the aortic arch may exclude distal arch aneurysms despite a short proximal neck.


1998 ◽  
Vol 46 (10) ◽  
pp. 971-975 ◽  
Author(s):  
Satoshi Kawaguchi ◽  
Shin Ishimaru ◽  
Taro Shimazaki ◽  
Yoshihiko Yokoi ◽  
Nobusato Koizumi ◽  
...  

Vascular ◽  
2005 ◽  
Vol 13 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Alfio Carroccio ◽  
David Spielvogel ◽  
Sharif H. Ellozy ◽  
Robert A. Lookstein ◽  
Iris Y. Chin ◽  
...  

Reconstruction of aortic arch and descending thoracic aortic aneurysms (TAAs) is technically challenging and associated with significant morbidity and mortality. We report our experience with extensive TAAs using a two-stage “elephant trunk” repair, with the second stage completed using an endovascular stent graft (ESG). Over 6 years, 111 patients underwent ESG treatment of TAAs at Mount Sinai Medical Center. Twelve of these patients were referred for ESG placement for the second stage of elephant trunk reconstruction because comorbidities placed them at high risk of open surgical repair. Our database was analyzed for technical and clinical success and perioperative complications. The mean follow-up was 11.8 months (range 1–64 months). Twelve patients (five women and seven men) with a mean age of 69 ± 10 years underwent repair of their distal aortic arch and descending TAAs. These aneurysms included nine atherosclerotic aneurysms, one pseudoaneurysm, and two penetrating atherosclerotic ulcers. Three patients were symptomatic. Stent graft repair was technically successful in 91.7% or 11 of 12 patients. Excessive aortic arch tortuosity resulted in failure to deploy a stent graft in one patient. An antegrade approach through the open elephant trunk was used in two patients with severe iliac occlusive disease. Endoleaks (type 2) were identified in two patients with no aneurysm expansion; however, a 14 mm expansion over 1 year occurred in a patient with no identifiable endoleak. One early mortality occurred in a patient with a ruptured 6 cm infrarenal AAA after successful exclusion of the 8 cm TAA. Second-stage elephant trunk reconstruction of an extensive TAA using an ESG is effective in the short term. Its long-term durability remains to be determined.


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