Contralateral occlusion is not a clinically important reason for choosing carotid artery stenting for patients with significant carotid artery stenosis.

Objective: Contralateral carotid artery occlusion by itself carries an increased risk of stroke. Carotid endarterectomy (CEA) in the presence of contralateral carotid artery occlusion has high reported rates of perioperative morbidity and mortality. Our objective was to determine if there is a clinical benefit to patients who receive carotid artery stenting (CAS) compared to CEA in the presence of contralateral carotid artery occlusion.

Carotid revascularization outcomes comparing distal filters, flow reversal, and endarterectomy.

Introduction: Contradictory outcomes exist for different methods of carotid artery revascularization. Here we provide the comparative rates of adverse events in patients after carotid endarterectomy (CEA), carotid artery stenting (CAS) with a distal embolic protection device (EPD), and CAS with a proximal flow reversal system (FRS) from a single institution by various specialists treating carotid artery disease.

Methods: Procedural billing codes and the electronic medical records of patients undergoing revascularization for carotid artery stenosis from February 2007 through March 2010 were used for data collection.

Branched grafts for thoracoabdominal aneurysms: off-label use of FDA-approved devices.

Purpose: To report off-label use of approved off-the-shelf endografts with no modification to the devices for the management of thoracoabdominal aneurysms (TAAA).

Technique: The parallel endograft octopus technique is demonstrated in a 68-year-old woman with a past history of open TAAA repair with a patch reimplant of the visceral vessels who now presented with back pain. Non-contrast computed tomography revealed a 6.

Thoracic endovascular aneurysm repair for thoracic aneurysms: what we know, what to expect.

Descending thoracic aneurysms are less common and less likely to rupture than abdominal aortic aneurysms. However, when left untreated they are lethal, and repairs are recommended only if the size of the aneurysm is 6 cm, or smaller if symptomatic. Open thoracic aneurysm repair was the standard therapy the last time this topic was reviewed in Annals of Vascular Surgery.

Incidence of and outcomes after misaligned deployment of the talent thoracic stent graft system.

Objective: Various types of device-specific adverse events can occur during deployment of thoracic stent grafts due to the high flow rate and severe aortic angulation that is often encountered in the thoracic aorta. This study assessed the incidence, etiology, and overall effect of misaligned deployment of the Talent Thoracic Stent Graft (TSG) System. Techniques to predict and avoid this complication are discussed.

Endovascular repair for diverse pathologies of the thoracic aorta: an initial decade of experience.

Background: Endovascular grafts have rapidly evolved as a minimally invasive treatment for a variety of acute and chronic disorders of the thoracic aorta. Application of this technology at a single center is reported.

Study Design: Between 1998 and 2007, 197 patients underwent thoracic endovascular aortic repair.

The phase I multicenter trial (STAPLE-1) of the Aptus endovascular repair system: results at 6 months and 1 year.

Objective: This phase I IDE study (STAPLE-1) evaluated the primary endpoints of safety (major device-related adverse events at 30 days) and feasibility (successful deployment of all endograft components) of the Aptus Endovascular abdominal aortic aneurysm (AAA) Repair System (Aptus Endosystems, Inc, Sunnyvale, Calif) to treat AAAs.

Methods: A prospective, single arm Federal Drug Administration (FDA) Phase I IDE study was performed. The Aptus endograft is a three-piece modular device with a flexible unsupported main body and two fully supported limbs in a 5.

A single-institution experience with the AneuRx Stent Graft for endovascular repair of abdominal aortic aneurysm.

We report our experience of endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) using the modular AneuRx Stent Graft System. We retrospectively reviewed the outcomes of 113 patients who underwent EVAR with the AneuRx system performed at our institution between October 1999 and August 2003. The mean age of this group was 72.

Visceral debranching to facilitate repair of complex thoracic and thoracoabdominal aneurysms.

The availability of thoracic and abdominal endografts has decreased the morbidity and mortality associated with the repair of aneurysms of the aorta. The current limitations of endografts for aneurysms involve adequate proximal and distal landing zones. Branches that are not critical, such as the internal iliac or left subclavian artery, may often be covered and included in the landing zone for most patients, with a few exceptions.

Future of endograft surveillance.

Frequent and sustained surveillance continues to be mandated for all patients who undergo endovascular repair of the aneurysmal aorta in order to minimize the small but attendant risk of aneurysm rupture. The primary motivation for surveillance includes evaluation of residual aneurysm sac size and presence of endoleak, as well as potential adverse device specific events, such as endograft migration, module disconnection, or component fatigue and failure. The current standard of care and future surveillance modalities after endovascular repair of both abdominal aortic and thoracic aortic aneurysms will be reviewed.

Secondary conversion of the Gore Excluder to operative abdominal aortic aneurysm repair.

Objective: Reports continue to document the occurrence of major adverse events after endovascular aortic aneurysm repair. Although many of these problems can be successfully managed through endovascular salvage, operative conversion with explantation of the endoprosthesis remains necessary in some patients. We report herein a review of all patients initially enrolled in multicenter US clinical trials of the Excluder endograft who underwent secondary conversion to open surgical repair.