scholarly journals Aortic neck evolution after endovascular repair with TriVascular Ovation stent graft

2016 ◽  
Vol 63 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Gianmarco de Donato ◽  
Francesco Setacci ◽  
Luciano Bresadola ◽  
Patrizio Castelli ◽  
Roberto Chiesa ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Aortic Neck

Stent-Graft Migration following Endovascular Repair of Aneurysms with Large Proximal Necks: Anatomical Risk Factors and Long-term Sequelae

2002 ◽  
Vol 9 (5) ◽  
pp. 652-664 ◽  
Author(s):  
James T. Lee ◽  
Jason Lee ◽  
Ihab Aziz ◽  
Carlos E. Donayre ◽  
Irwin Walot ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Morphological Changes ◽  
Morphological Characteristics ◽  
Anatomical Characteristic ◽  
Computed Tomographic ◽  
Aortic Neck ◽  
Distal Migration ◽  
Graft Migration ◽  
Over Time

Purpose: To evaluate the outcome of aortic endografts deployed in large infrarenal necks and to identify any association of preoperative aneurysm characteristics and postoperative morphological changes with the incidence of neck dilatation and device migration in this patient subset. Methods: The records of 47 patients (41 men; mean age 74, range 55–84) with large aortic neck diameters treated with Talent stent-grafts from 1998 to 2001 were reviewed. Patients with anatomical criteria that precluded aneurysm exclusion with currently available devices were preferentially selected. Mean baseline aneurysm morphology included 27.6-mm (range 18–33.4) suprarenal and 28.1-mm (range 24–34) infrarenal neck diameters; the infrarenal neck length was 26 ± 16 mm with angulation of 37° ± 18°. Computed tomographic (CT) angiograms up to 3 years were analyzed using specialized interactive software; migration was defined as >1-cm change in the distance from the lower renal artery to the top of the device. Pre- and postoperative morphological characteristics of the aneurysm were compared between patients with and without migration. Results: Of the 45 patients successfully treated, 40 had complete CT data for analysis. During a mean 17-month follow-up, 7 (17.5%) of the 40 devices exhibited distal migration. Six patients required secondary procedures; 5 were in the migration cohort. No preoperative anatomical characteristic or degree of neck dilatation over time was predictive of stent-graft migration. Aneurysm sac regression was significant at 1 (–0.09 ± 4.90 mm) and 2 (–1.48 ± 2.56 mm) years in endografts without migration (p<0.001). Distal endograft migration >1 cm predicted the need for secondary interventions (p<0.001), with 83% sensitivity and 94% specificity. Conclusions: Endovascular repair is successful in patients with large infrarenal necks and complex neck morphology. Changes in aneurysm remodeling over time were similar to reported observations in patients with more favorable neck criteria. Although no anatomical factor associated with migration could be identified from this analysis, distal displacement >1 cm correlated with the need for a secondary intervention.

Endovascular Repair of Thoracic Aortic Aneurysm in Dogs:Evaluation of a Nitinol-Polyester Self-Expanding Stent-Graft

2000 ◽  
Vol 7 (1) ◽  
pp. 47-67 ◽  
Author(s):  
Maxime Formichi ◽  
Yves Marois ◽  
Patrice Roby ◽  
Georgui Marinov ◽  
Patrick Stroman ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Thoracic Aortic Aneurysm

scholarly journals Endovascular repair of de novo post-stenotic aortic coarctation aneurysms with complex collateral supply: two cases with long and medium term follow-up

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Omar Abdel-Hadi ◽  
John Thomson ◽  
Simon J. McPherson
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Aortic Coarctation ◽  
De Novo ◽  
Aortic Aneurysms ◽  
Medium Term ◽  
First Case ◽  
Case Presentations ◽  
Selective Embolisation

Abstract Purpose To report the technical details and outcomes of the endovascular repair of two cases of de novo post-stenotic aortic coarctation aneurysms complicated by complex collateral supply. Case presentations Two patients with thoracic aortic aneurysms complicated by complex aneurysm sac collaterals distal to a previously untreated thoracic aortic coarctation have been treated at our institution. Open surgical intervention was deemed to carry a high risk of haemorrhage due to the degree and complexity of arterial collateralisation. In the first case, selective embolisation of collateral vasculature was performed prior to successful exclusion of the aneurysm with a thoracic endovascular stent-graft and then balloon-expandable stent dilatation of the coarctation stenosis. In the second case, the additional technique of using a jailed sheath within the aneurysm sac allowed for selective embolisation of previously inconspicuous collaterals after deployment of the stent-graft and stent combination. Results Technical success was achieved in both patients with successful occlusion of the aneurysm, with no recorded complications or aneurysm sac perfusion in the long and medium term follow up periods respectively. Conclusion De novo post stenotic aortic coarctation aneurysms are rare. Endovascular repair is a safe and durable technique that provides a less invasive alternative to open surgical repair. The use of a jailed sheath allows for complete selective embolisation of complex collaterals avoiding a type II aneurysm endoleak.

Aortic endograft and bridging stent-graft remodeling after branched endovascular aortic repair

Vascular ◽  
2020 ◽  
pp. 170853812098369
Author(s):  
Stefano Fazzini ◽  
Giovanni Torsello ◽  
Martin Austermann ◽  
Efthymios Beropoulis ◽  
Roberta Munaò ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Main Body ◽  
Thoracoabdominal Aneurysm ◽  
Before And After ◽  
Long Term Follow Up ◽  
Instability Rate ◽  
One Year ◽  
The Impact

Objectives The results of branched endovascular repair of thoracoabdominal aneurysms are mainly dependent on durability of the graft used. The purpose of this study was to evaluate postoperative aortic main body and bridging stent-graft remodeling, and their impact on bridging stent-graft instability at one year. Methods Computed tomoangiographies of 43 patients (43 aortic main body mated with 171 bridging stent-grafts) were analyzed before and after branched endovascular repair as well as after a follow-up of 12 months. Primary endpoint was aortic main body remodeling (migration >5 mm, shortening >5 mm, scoliosis >5° or lordosis >5°). Shortening was defined as a reduced length in the long axis, scoliosis as left-right curvature, and lordosis as antero-posterior curvature. Aortic main body remodeling, aneurysm sac changes, and bridging stent-graft tortuosity were evaluated to study their correlations and the impact on the bridging stent-graft instability. Results At 12 months, aortic main body remodeling was observed in 72% of the cases, migration in 39.5% (mean 5.21 mm), shortening in 41.9% (mean 5.79 mm), scoliosis in 58.1%, (mean 10.10°), lordosis in 44.2% (mean 5.78°). Migration, shortening, and scoliosis were more frequent in patients with larger aneurysms ( p = .005), while scoliosis was significantly more frequent in type II thoracoabdominal aneurysm ( p = .019). Aortic main body remodeling was significantly associated to bridging stent-graft remodeling (r: 0.3–0.48). The bridging stent-graft instability rate was 9.3%. Despite a trend toward significance ( p = .07), none of the evaluated aortic main body and bridging stent-graft changes were associated with bridging stent-graft instability at 12 months. Conclusions Aortic main body remodeling is frequent especially in large and extended thoracoabdominal aneurysm aneurysms. Aortic main body and bridging stent-graft remodeling was significantly correlated. While these geometric changes had no significant impact on bridging stent-graft instability at one year, a close long-term follow-up after branched endovascular repair could predict bridging stent-graft failures.

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