Unsuspected Limitations of 3D Printed Model in Planning of Complex Aortic Aneurysm Endovascular Treatment.

Objective: Static 3-dimensional (3D) printing became attractive for operative planning in cases that involve difficult anatomy. An interactive (low cost, fast) 3D print allowing deliberate surgical practice can be used to improve interventional simulation and planning.

Background: Endovascular treatment of complex aortic aneurysms is technically challenging, especially in case of narrow aortic lumen or significant aortic angulation (hostile anatomy).

Unusual Endovascular Treatment of Iliac Occlusive Disease With a Physician-Modified Endograft to Preserve a Transplant Renal Artery.

Purpose: We describe the feasibility and early results of iliac stenting using a physician-modified endograft (PMEG) to preserve a transplant renal artery in patient with iliac occlusive disease.

Case Report: A 70-year-old male patient, with sub-occlusive left common iliac artery stenosis at the level of the transplanted kidney arterial anastomosis, presented with left critical limb ischemia (CLI) and pseudo-transplant renal artery stenosis (pseudo-TRAS) symptoms. He was treated with a physician-modified fenestrated covered stent introduced percutaneously via ipsilateral femoral artery after failure of simple angioplasty (percutaneous transluminal angioplasty, PTA).

Endovascular aortic repair with the Gore Excluder Conformable endograft in severe neck angulation: Preliminary experience and technical aspects.

Objectives: Endovascular procedures are now the standard of care for endovascular aortic aneurysm repair but treatment of hostile proximal neck anatomy is still challenging. New endografts were brought to the market specifically designed to accommodate severe neck angulation. Authors describe a preliminary experience and early results using the Gore Excluder Conformable endograft (W.

Endovascular Aortic Repair with the "Step-by-Step" Deployment of the Endurant Stent-Graft System in Severe Neck Angulation: Technique and Review of the Literature.

Objectives: To describe a new technique based on a different deployment of the Endurant Stent-Graft System (Medtronic Cardiovascular, Santa Rosa, CA) during endovascular aortic aneurysm repair to guarantee a more precise deployment in presence of severe neck angulation (SNA).

Technique: The "step-by-step" deployment technique consists of an alternate partial release of the main body and of the free-flow suprarenal stents to approximate the radiopaque markers of the graft fabric to the aortic wall, obtaining a more precise delivery, reducing the possibility of downward dislodgments along the external curve of the infrarenal angle and asymmetrical deployments in presence of SNA.

Conclusions: The "step-by-step" technique is a simple, safe, and effective graft-deployment method, which allows a very precise release in SNA and possibly achieves better results in the long-term period in such difficult anatomies.

Technical Success and Long-Term Results with Excluder/C3 Endoprosthesis in Narrow Aortic Bifurcations: First Italian Multicentre Experience.

Background: This study aims at evaluating technical success and long-term results using Gore Excluder/C3 endoprosthesis in patients with narrow aortic bifurcation (NAB; inner aortic diameter < 18 mm).

Methods: Clinical and anatomical data were collected retrospectively from patients treated in 2 high-volume Italian vascular centers between 2005 and 2017. A total of 1325 endovascular aneurysm repair procedures were performed, of which 195 involved Excluder/C3 Gore endoprosthesis.