The remarkable advances in technology and devices in the last two decades have made possible the endovascular repair of complex abdominal (cAAA) and thoracoabdominal (TAAA) aortic aneurysms with challenging anatomy. To date, despite the creation of multiple fenestrated/branched endografts intended to treat these difficult cases, in the USA, many of them remain available only under physician sponsored investigational device exemption (PSIDE) protocols in few institutions. The Gore Thoracoabdominal Branched Endoprosthesis (TAMBE; W.L. Gore & Associates, Flagstaff, AZ, USA) investigational device is a four-branched off-the-shelf (OTS) endograft that concluded an early feasibility study in 2016 and is currently finalizing a pivotal trial in pursuit of approval from the Food and Drug Administration. This article discusses the TAMBE early feasibility multicenter study results, the most relevant features of this device, its anatomical feasibility, and the impressions about this endograft as an OTS option for the treatment of CAAA and TAAA.
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http://dx.doi.org/10.23736/S0021-9509.23.12717-0 | DOI Listing |
JTCVS Open
December 2024
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex.
Background: We have developed a model aimed at identifying preoperative predictors of operative mortality in patients who undergo elective, open thoracoabdominal aortic aneurysm (TAAA) repair. We converted this model into an intuitive nomogram to aid preoperative counseling.
Methods: We retrospectively analyzed data from 2884 elective, open TAAA repairs performed between 1986 and 2023 in a single practice.
Can J Surg
December 2024
From the Cumming School of Medicine, University of Calgary, Calgary, Alta. (Krzyzaniak, Vergouwen, Van Essen, Nixon); the Department of Surgery, Section of Vascular Surgery, University of Calgary, Calgary, Alta. (Krzyzaniak, Moore, Rommens); the Department of Cardiac Sciences, Section of Cardiac Surgery, University of Calgary, Calgary, Alta. (McClure); the Calgary Aortic Program, Calgary, Alta. (McClure, Moore, Rommens); the Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, Alta. (Nixon, Jadavji).
Background: Cerebrospinal fluid (CSF) drainage is used to reduce spinal cord ischemia (SCI) in patients undergoing thoracoabdominal aortic procedures. Recent literature has found high rates of complication associated with CSF drainage, which has led to changes in practice. The aim of this study was to investigate rates of CSF drain-related complications in patients undergoing a thoracoabdominal aortic procedure with perioperative placement of a CSF drain.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
February 2025
Division of Vascular Surgery, University of California Davis Medical Center, Sacramento, CA.
Degeneration of the thoracoabdominal aorta proximal to a prior fenestrated endovascular aortic repair represents a complex issue with limited options for repair. Previously, modified endografts or open conversion with endograft explant offered the only options for management. Here we describe use of the Gore Thoracoabdominal Multibranch Endoprosthesis for exclusion of an extent III thoracoabdominal aneurysm in the setting of degeneration proximal to a previously placed fenestrated device.
View Article and Find Full Text PDFJ Vasc Surg
November 2024
Department of Vascular Surgery, Cleveland Clinic Foundation, Cleveland, OH. Electronic address:
Ann Surg
November 2024
Department of Cardiothoracic and Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
Objective: To compare target artery (TA) outcomes after fenestrated or branched endovascular aortic repair (FB-EVAR) versus open surgical repair (OSR) of thoracoabdominal aortic aneurysms (TAAAs).
Background: Few studies have compared TA outcomes after endovascular incorporation and open reconstruction.
Methods: Among consecutive patients who underwent elective OSR or FB-EVAR of TAAAs (2008-2020), we reviewed those who had postoperative imaging studies evaluating TA.
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