A Custom-Made Treovance ® Abdominal Aortic Aneurysm Endograft to Correct Late Failure of Trombone Technique with a Tube Endograft
| Autor: | Christos Argyriou, George S. Georgiadis, Miltos K. Lazarides, Christina D. Valsamidou, Alexandrina Nikova |
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| Rok vydání: | 2018 |
| Předmět: |
Marfan syndrome
medicine.medical_specialty medicine.diagnostic_test business.industry Context (language use) General Medicine Aortic bifurcation 030204 cardiovascular system & hematology 030230 surgery medicine.disease Abdominal aortic aneurysm Surgery 03 medical and health sciences Aortic aneurysm 0302 clinical medicine medicine.anatomical_structure Blood vessel prosthesis medicine Cardiology and Cardiovascular Medicine business Abdominal surgery Computed tomography angiography |
| Zdroj: | Annals of Vascular Surgery. 49:311.e1-311.e9 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2017.10.029 |
| Popis: | Background Unfavorable anatomy is one of the major limitations of endovascular aortic aneurysm repair (EVAR) with specifically adverse proximal neck morphology excluding many patients from receiving the standard endograft devices. Thoracic tube endografts have been used to overcome the issue of wide infrarenal necks, either as a sole device (single tubes or double tubes using the trombone technique) or as the proximal part of a bifurcated device fixed to the aortic bifurcation or infrarenally oriented. However, custom-made large proximal diameter bifurcated endograft designs have never been used. Methods We present the case of a 56-year-old man with Marfan syndrome, suffering abdominal aortic aneurysm (AAA) enlargement from a type Ib endoleak after previous EVAR with 2 Endofit tube endografts (trombone technique). He was considered unfit for open surgery while possible alternatives such as fenestrated endovascular AAA repair and chimney technique were excluded. Results The patient was treated with a custom-made 44-mm proximal diameter, bifurcated Bolton Medical Treovance device with technical and clinical success. No immediate or perioperative complications were noted. Follow-up after 6 months showed graft patency and no endoleak of any type. Conclusions This alternative technique for hostile proximal neck management is promising and needs long-term follow-up; an issue which is discussed within the broader context of custom-made device regulations. |
| Databáze: | OpenAIRE |
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