| 1. |
- Resch, Tim, et al.
(author)
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Development of Off-the-shelf Stent Grafts for Juxtarenal Abdominal Aortic Aneurysms.
- 2012
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In: European journal of vascular and endovascular surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 43:6, s. 655-660
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Journal article (peer-reviewed)abstract
- INTRODUCTION: The use of EVAR for more complex aneurysm anatomy has become more widespread over the past decade. Fenestrated and branched stent grafts for the visceral and iliac segment show promising short- and midterm outcome and these procedures have become routine in many vascular centers. However, at present, such grafts are customized to the individual patient and planning and manufacturing leads to significant treatment delay subjecting the patients to the risk of rupture during the waiting period. The purpose of this report is to describe the first experience in treating juxta/suprarenal aneurysms using the first version of a new fenestrated stent graft MATERIAL AND METHODS: A fenestrated device was designed with two renal fenestrations, an SMA fenestration and a scallop for the coeliac artery. The renal arteries were designed with an inner 6 mm fenestration and an outer 15 mm diameter creating a dome to allow renal artery catheterization for a range of renal artery distribution. Seven patients with complex visceral artery anatomy were treated with customized stent grafts containing these pivot renal fenestrations. RESULTS: Technical success was uniform with 100% target vessel catheterization and 0% 30-day mortality. In one case, the graft was displaced slightly during delivery resulting in a renal artery stent occlusion at 2 months postoperatively. CONCLUSIONS: The development of a modified fenestrated device has shown this to be feasible and it has the potential to reduce the need for extensive preoperative graft customization and establishing a true off the shelf platform for juxta- and suprarenal AAA.
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| 2. |
- Sobocinski, J., et al.
(author)
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Endograft Repair of Complicated Acute Type B Aortic Dissections
- 2013
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 45:5, s. 468-474
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Journal article (peer-reviewed)abstract
- Objectives: This study aims to assess patient outcomes and aortic remodelling following coverage of the proximal entry tear with an endograft in complicated acute type B aortic dissections (caTBADs). Material and methods: All patients with caTBAD treated with a thoracic endograft in three high-volume vascular centres were retrospectively studied. Inclusion criteria were branch-vessel malperfusion, impending or overt aortic rupture, maximal aortic diameter >= 40 mm and persistent pain or uncontrolled hypertension despite maximum pharmacological treatment. Postoperative aortic remodelling was evaluated using computed tomography angiography (CTA). on a three-dimensional (3D) imaging workstation. Results: A total of 52 patients (71% male, median age 65 years) were included in the study. Median inclusion criteria per patient were 2 (range 1-4). Branch-vessel malperfusion was diagnosed in 42% and impending aortic rupture in 33% of 52 patients. Median follow-up was 25 months (range 2-109 months). The 30-day mortality rate was 9.6% (5/52); patient survival according to the Kaplan-Meier method was 90.4% at 12 months and 87.6% at 24 months. Secondary interventions were performed in seven patients a median of 3 days after the initial procedure (range 2-865). Imaging follow-up at 12 months was performed in 36 patients (69%): 75% presented stable or shrinking (>5 mm) maximal aortic diameters and 86% had a completely thrombosed false lumen (vs. 5% before initial procedure) at thoracic level. Conclusion: Endograft treatment of complicated caTBAD is associated with favourable early outcomes and possibly promotes aortic remodelling in the majority of patients. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
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| 3. |
- Sobocinski, J., et al.
(author)
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Fenestrated and branched technology: what's new?
- 2012
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In: Journal of Cardiovascular Surgery. - 0021-9509. ; 53:1, s. 73-81
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Journal article (peer-reviewed)abstract
- This review article presents the latest published clinical series evaluating fenestrated and branched endografts for the treatment of complex aortic aneurysms incorporating the visceral branches, iliac arteries and supra-aortic trunks. In addition, an overview of the recent developments in devices and imaging modalities is also proposed.
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