Novel Technique for the Treatment of Type Ia Endoleak After Endovascular Abdominal Aortic Aneurysm Repair
| Autor: | Kyriakos Oikonomou, Wacław Kuczmik, Karin Pfister, Wilma Schierling, Piotr M. Kasprzak, Georgios Sachsamanis |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
type Ia endoleak
Novel technique medicine.medical_specialty Endoleak 610 Medizin 030204 cardiovascular system & hematology Prosthesis Design Aortography custom-made device type Ia endoleak bEVAR EVAR EVAS additional branch custom-made device Blood Vessel Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine medicine Humans EVAR additional branch Radiology Nuclear Medicine and imaging 030212 general & internal medicine EVAS Surgical repair ddc:610 Aortic aneurysm repair business.industry Endovascular Procedures bEVAR Perioperative medicine.disease Abdominal aortic aneurysm Blood Vessel Prosthesis Surgery Treatment Outcome Stents Technical Notes Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Endovascular Therapy |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1177/15266028211010469 |
| Popis: | Purpose Open surgical repair of type Ia endoleak after endovascular aortic aneurysm repair/sealing (EVAR/EVAS) is associated with significant perioperative mortality and morbidity. Current endovascular redo techniques face limitations, especially when the infrarenal landing zone is inadequate and the previous endograft is rigid and features a short or no main body. We present a novel concept for the treatment of type Ia endoleak using a custom-made branched device. Technique The 5-branch-device (Cook Medical, Bloomington, IN, USA) consists of a nitinol skeleton with branches, covered with a low-profile polyester fabric loaded in an 18F sheath. The device features a minimum of 2 proximal sealing stents and includes branches for renovisceral vessels as well as an additional 8 mm branch for the contralateral iliac limb. Implantation and sealing in the renovisceral vessels is carried out in standard fashion, using transfemoral and transaxillary access. Distal sealing is achieved by tapering the branched component into the ipsilateral iliac limb and using a bridging balloon-expandable or self-expandable stent-graft through the additional branch to the preexisting contralateral iliac limb. Conclusion Treatment of type Ia endoleak with a new custom-made device enables sufficient proximal seal while minimizing suprarenal aortic coverage and facilitates adequate component overlap. The low profile branched design accommodates implantation through the preexisting endograft and catheterization of target vessels. |
| Databáze: | OpenAIRE |
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