AI Article Synopsis
- The study evaluated the compatibility of abdominal aortic aneurysm (AAA) treatments using fenestrated devices and stents in parallel, focusing on their alignment with a new endograft option called p-branch.
- Approximately 73.2% of the treated cases showed anatomical compatibility with the p-branch, although many patients required more fenestrations than what was used in practice.
- The findings suggest that the p-branch could effectively address many AAA cases, potentially reducing costs and waiting times while highlighting the need for more fenestrations in some scenarios.
Article Abstract
Background: In the endovascular treatment of abdominal aortic aneurysm (AAA) with short or absent infrarenal neck, the delay in the availability of fenestrated device and its high cost, have led to the manufacture of standardized models. Another option is the endografts with stents in parallel; however, regulated criteria for their use and long-term studies are lacking. The aim of this study was to assessed whether the AAA treated with fenestrated device or stents in parallel in our department, complied with the characteristics for the placement of the new endograft p-branch(®). Furthermore, the differences between the p-branch and the implanted prosthesis were analyzed.
Methods: Single-center and descriptive study of 41 aneurysms treated consecutively from 2008 to 2015. The anatomic characteristics analyzed were: relative distances between the visceral arteries, time position, diameter in the sealing area and number of fenestrations, and its compatibility with the p-branch.
Results: The anatomic compatibility rate with the p-branch options was 73.2% (30 cases). Of the 11 incompatible cases, 6 were due to misalignment of the visceral branches, 2 due to the aortic neck diameter being greater, another because the femoral access was inappropriate, and 2 more due to the fenestration configuration. Of the 30 cases in which compatibility existed, in 12 (40%) the configuration used coincided with the p-branch. In 13 cases, the number of fenestrations was higher than those actually used, with 23 fenestrations carried out and 39 hypothetical fenestrations with the new endograft. In the 5 remaining cases, a fenestration for the celiac trunk was necessary to achieve an adequate seal.
Conclusions: The p-branch could meet the needs of three-quarters of the aortic anatomies of our series, with favorable expectations on cost and waiting time. However, in most cases either a higher number of fenestrations are needed for visceral arteries or the proximal seal was shorter than would be ideal.
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| http://dx.doi.org/10.1016/j.avsg.2015.09.030 | DOI Listing |
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Article Synopsis
- - This study explored how the location of re-entry tears affects blood flow and pressure in uncomplicated type B aortic dissection using computer simulations based on CT images.
- - The simulations showed that models with re-entry tears generally had lower blood pressure and wall shear stress compared to those without, especially when the tear was near the end of the false lumen.
- - The findings could help inform fenestration surgery in these patients, but more research with a larger patient pool is needed to validate the results.
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