Anatomic feasibility of off-the-shelf fenestrated stent grafts to treat juxtarenal and pararenal abdominal aortic aneurysms

Abstract

The p-Branch design has greater anatomic feasibility and achieves proximal seal in all patients with juxtarenal and pararenal AAAs but is not able to incorporate visceral arteries in 40% of patients. The Ventana design allows incorporation of the visceral arteries in 90% of patients but fails to provide sufficient seal in 40%. Nearly 40% of juxtarenal and pararenal AAAs do not meet anatomic criteria for endovascular repair with one of the two devices, justifying the need for additional designs.

The Current State of Fenestrated and Branched Devices for Abdominal Aortic Aneurysm Repair

“…Between the two devices, nearly 40% of patients with juxtarenal and pararenal AAAs did not meet anatomic criteria for either device. 30 Similar findings regarding the Endologix Ventana and Cook p-Branch device were reported by Farber et al in 2014. Between July 2012 and September 2013, 85 patients were identified as type 4 thoracoabdominal aortic aneurysms including pararenal and juxtarenal aneurysms.…”

Performance of Bridging Stent Grafts in Fenestrated and Branched Aortic Endografting

“…2 In general, a modular strategy is used to connect different devices with an aortic main body (AMB). This is characterized by a dedicated region working as junction point.…”

Haemodynamic Variations of Flow to Renal Arteries in Custom-Made and Pivot Branch Fenestrated Endografting

“…Another off the shelf graft, the Ventana system, 23 was reported to have a much higher suitability than the pbranch device. 24 However, a clinical trial was halted because of a high incidence of adverse events in the renal arteries. At this point, the p-branch graft appears to be a feasible solution, but further evidence is necessary to validate its widespread use.…”