Purpose: The visualization of peripheral in-stent restenosis using energy-integrating detector CT is challenging due to deficient spatial resolution and artifact formation. This study compares the first clinically available photon-counting detector CT to third-generation dual-source energy-integrating detector CT.
Materials And Methods: Nylon cylinders with central bores (4 mm, 2 mm), mimicking 75% and 95% stenoses, were placed inside seven different 8-mm diameter stents and filled with diluted contrast medium.
Objective: Bridging stentgrafts (BSGs) are one of the primary limiting factors regarding long-term results after fenestrated endovascular aortic repair (fEVAR). This study aims to report for the first time the outcome of a novel BSG called iCover from a national, multicentric retrospective database.
Methods: A cohort of 58 patients received 212 BSGs for the renovisceral arteries in fEVAR.
Objectives: Endovascular treatment has been suggested as an alternative for open surgery for type A aortic dissection, but current devices have severe anatomical limitations. This study assesses the computed tomography-based anatomical suitability of currently manufactured stent grafts as well as 2 embodiments of valve-carrying devices.
Methods: In a retrospective single-centre cohort of 200 consecutive ascending/arch operations between 2009 and 2018, a total of 112 patients with type A aortic dissections were identified and evaluated for endovascular candidacy based on the locations of the entries, the landing zone diameters/lengths and the supra-aortic vessel origins according to the anatomical instructions for use criteria of 6 commercially available (tubular, branched or fenestrated) stent grafts.
Purpose: In penetrating aortic ulcers (PAUs), limited data support tubular thoracic endovascular aortic repair (TEVAR) as a viable treatment option. For treatment of more proximal PAUs, hybrid approaches and-more recently-scalloped TEVAR (scTEVAR) have been advocated. Outcomes of scTEVAR specifically for PAUs have not yet been reported.
View Article and Find Full Text PDFAll patients who underwent endovascular aortic repair (EVAR) need a thorough follow-up, at least yearly. Contrast-enhanced ultrasound and computed tomography angiography (CTA) are the most important modalities for detection of endoleaks, whereby CTA allows better differentiation of endoleak type. High pressure endoleaks (type I and III) are an absolute indication for treatment if they do not resolve spontaneously in the short term.
View Article and Find Full Text PDFBackground: Today, complex abdominal aortic pathologies involving the visceral arteries and without an adequate proximal neck can be treated using fenestrated/branched endovascular aortic repair (FEVAR/BEVAR) with similar safety and success rates as infrarenal aortic pathologies treated with tubular EVAR.
Methodical Innovations And Challenges: Fenestrations (if the vessel originates from a nondilated aorta) or branches (if the vessel originates from a dilated aorta) may be used for the visceral arteries. Both types of openings are sealed via bridging stent grafts that connect to the target vessel.
Objective: For thoracic endovascular aortic repair of the arch, branched and fenestrated endografts are available with different limitations regarding anatomy and extent of the pathology. Comparisons are lacking in the literature. The aim of this study was to compare the results of 2 currently commercially available devices for branched thoracic endovascular aortic repair and fenestrated thoracic endovascular aortic repair.
View Article and Find Full Text PDFPurpose: To compare bridging stent graft (BSG) implantation in downward oriented branches in branched endovascular aortic repair (bEVAR), using a commercially available steerable sheath from an exclusively femoral access (TFA) with traditional upper extremity access (UEA).
Methods: In a retrospective cohort study, 7 patients with 19 branches in the TFA cohort received BSG insertion using the Medtronic Heli FX steerable sheath from a femoral access, and 10 patients with 32 branches in the UEA cohort from a brachial approach. Technical success, total intervention time, fluoroscopy time, branch cannulation time, and complication rate were recorded.
Objective: To present a case series of spontaneous structural failure of bridging stentgrafts (BSGs) after branched endovascular aortic repair (bEVAR), as well as their failure types and their detection. While bEVAR is a safe and effective procedure, one main limitation is the reintervention rate associated with the BSGs. Structural failure of BSGs, defined as fabric disruption, stent fracture with leak or complete separation is a major cause for reinterventions and difficult to detect in computed tomography angiography (CTA).
View Article and Find Full Text PDFPurpose: To test a stent-graft specifically designed for the ascending aorta in phantom, cadaver, and clinical application, and to measure deployment accuracy to overcome limitations of existing devices.
Methods: A stent-graft has been designed with support wires to fixate the apices toward the inner curvature, thereby eliminating the forward movement of the proximal end which can happen with circumferential tip capture systems. The device was deployed in three aortic phantoms, and in four cadavers, deployment precision was measured.