Our patient had undergone a previous three-fenestration Anaconda (Terumo Medical Corp, Tokyo, Japan) fenestrated endovascular aneurysm repair (EVAR) to treat a juxtarenal aortic aneurysm. At 10 years postoperatively, distal migration of the prosthesis, a proximal type I endoleak, and aortic sac enlargement of 10 mm in 6 months was observed. Because of the short length of the Anaconda's bifurcated body, we chose to use a Zenith custom-made endograft with four branches and a bifurcated body with an inverted contralateral limb. We have also described the issues that can arise during branched EVAR after fenestrated EVAR and some of the bailout techniques we performed to successfully perform the treatment.
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http://dx.doi.org/10.1016/j.jvscit.2020.12.017 | DOI Listing |
Expert Rev Med Devices
January 2025
Long Beach Memorial Medical Center, MemorialCare Heart & Vascular Institute, Long Beach, CA, USA.
Introduction: Since the mid-1900s, techniques in the repair of aortic arch and thoracoabdominal aortic pathologies have drastically evolved. Open aortic surgical repair was once the sole option for both simple and complex aneurysmal degeneration. Today, a number of minimally invasive and hybrid approaches are now available to assist both the surgeon and patient in tackling this challenging problem.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
February 2025
Division of Vascular and Endovascular Surgery, Cardio-Thoracic-Vascular Department, Integrated University Healthcare Giuliano-Isontina, University Hospital of Cattinara, Trieste, Italy.
In the past 15 years, fenestrated-branched endovascular aortic repair (F-BEVAR) has progressively become the first-line option for management of most complex abdominal aortic aneurysms (AAAs); with increasing experience, as well as persistent technological refinements, F-BEVAR indications have been expanded to include rescue of failures after prior EVAR. Despite the feasibility and effectiveness, F-BEVAR procedures in the presence of prior infrarenal endografts may come with higher technical complexity that should be properly anticipated, and several anatomical challenges can be expected. Among these, presence of suprarenal bare stents from prior EVAR device are certainly a frequent scenario and may sometimes make target vessel cannulation more difficult because of encroachment on the target vessel origins.
View Article and Find Full Text PDFEur J Vasc Endovasc Surg
December 2024
Division of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Objective: Emergent complex abdominal aortic diseases are challenging to treat. During in situ laser fenestration (ISLF), aortic branches are covered and flow is restored with in situ fenestration of the stent graft, with promising midterm results. This study aimed to expand on the limited body of knowledge of midterm outcomes of ISLF in renovisceral aortic pathology in a multicentre setting.
View Article and Find Full Text PDFAnn Vasc Surg
December 2024
Department of Interventional Radiology, Semmelweis University, Budapest, Hungary; Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address:
Objective: Open surgical suprarenal aortic fenestration (OSSAF) is a technique to treat complicated type B aortic dissection (cTBAD) by resecting the intimal membrane at the level of the visceral arteries. This invasive procedure is largely abandoned since the advent of thoracic endovascular aortic repair (TEVAR) as becoming the gold standard of treating cTBAD. Identifying patterns in the late history of patients who underwent OSSAF might help better understand the evolution of TBAD.
View Article and Find Full Text PDFJ Endovasc Ther
December 2024
Department of Vascular and Endovascular Surgery, Klinik Ottakring, Wiener Gesundheitsverbund, Wien, Austria.
Objective: This study offers a retrospective assessment of a single-center experience using cerebrospinal fluid catheters to reduce the risk of perioperative spinal cord injury in patients undergoing single-staged complex endovascular juxtarenal or thoracoabdominal aortic aneurysm repair.
Results: A total of 97 patients were included. On average, 70.
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