Changes in aneurysm morphology and stent-graft configuration after endovascular repair of aneurysms of the descending thoracic aorta

Resch, Timothy; Koul, Bansi; Dias, Nuno; Lindblad, Bengt; Ivancev, Krassi

doi:10.1067/mtc.2001.113025

Cited by 63 publications

(49 citation statements)

References 19 publications

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“…TAA endoleaks occur more commonly at the proximal or distal attachment sites (type I endoleak), whereas the majority of AAA endoleaks are type II. 94 It is generally accepted that type I endoleaks are more serious and require expeditious intervention because they represent direct communications between the aneurysm sac and aortic blood flow. 95 Treatment options include transcatheter coil or glue embolization, balloon angioplasty, placement of endovascular graft extensions, and open repair.…”

Section: Complicationsmentioning

confidence: 99%

Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

et al. 2005

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Section: Complicationsmentioning

confidence: 99%

Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

et al. 2005

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“…Since MDCTA is a very accurate imaging modality, an additionally performed calibrated intra-arterial DSA was not necessary. Concerning the morphologic changes of a thoracic aneurysm after successful endovascular exclusion, it has recently been demonstrated that excluded thoracic aortic aneurysms decrease in size similar to those found in abdominal aneurysms (approximately 10% yearly [6], 4 mm at 12-month follow-up) [21]. In our population we could demonstrate in 2 cases a decrease of aneurysm size of 4-5 mm after 1 year.…”

Section: Discussionmentioning

confidence: 57%

Urgent thoracic aortal dissection and aneurysm: treatment with stent-graft implantation in an angiographic suite

et al. 2003

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The aim of this study was to evaluate the feasibility of endoluminal stent-graft placement in an angiographic suite for the treatment of emergent type-B aortic dissections and ruptured thoracic aortal aneurysms. Twenty-six patients with either urgent type-B dissection (n=8) or aneurysms (n=18) of the descending thoracic aorta were chosen for stent-graft implantation. All patients received a multidetector-row CT angiography of the whole aorta and pelvic arteries prior to stent-graft implantation. All procedures were performed in a fully equipped digital subtraction angiography (DSA) suite under general anesthesia. In 20 patients Talent LPS tube grafts and in 4 patients an Excluder graft were used. Access was achieved via surgical cut-down in the left (n=7) or right (n=19) groin. Sealing was successful in 24 patients. The proximal covered portion of the stent graft was placed across the left subclavian artery in 2 patients. Procedural success was achieved in 23 of 24 patients. One patient required a second stent-graft placement before the aneurysm was sealed. One patient with an acute perforation of the descending aorta died due to cardiac failure prior to stent-graft implantation. In 1 patient stent-graft delivery failed due to severe calcification of both common iliac arteries. Endoluminal treatment of both urgent type-B aortic dissections and thoracic aortal aneurysms with stent graft is an attractive alternative treatment to surgical repair. The placement of stent grafts in an angiographic suite is a safe and feasible method with good clinical effectiveness and, so far, good clinical outcome.

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“…Our experimental testing proved that the anatomical stent significantly decreases the external strain force at both ends of the stent compare with that of the straight stent. By forming the Nitinol stent to match the expected change in aortic shape during the follow-up period [14][15][16], complications may be lessened as well.…”

Section: Discussionmentioning

confidence: 96%

Creation of individual ideally shaped stents using multi-slice CT: in vitro results from the semi-automatic virtual stent (SAVS) designer

et al. 2005

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To plan stent-grafting for thoracic aortic aneurysm with complicated morphology, we created a virtual stent-grafting program [Semi Automatic Virtual Stent (SAVS) designer] using three-dimensional CT data. The usefulness of the SAVS designer was evaluated by measurement of transformed anatomical and straight stents. Curved model images (source, multi-planer reconstruction and volume rendering) were created, and a hollow virtual stent was produced by the SAVS designer. A straight Nitinol stent was transformed to match the curved configuration of the virtual stent. The accuracy of the anatomical stent was evaluated by experimental strain phantom studies in comparison with the straight stent. Mean separation length was 0 mm in the anatomical stent [22 mm outer diameter (OD)] and 5 mm in the straight stent (22 mm OD). The straight stent strain voltage was four times that of the anatomical stent at the stent end. The anatomical stent is useful because it fits the curved structure of the aorta and reduces the strain force compared to the straight stent. The SAVS designer can help to design and produce the anatomical stent.

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Changes in aneurysm morphology and stent-graft configuration after endovascular repair of aneurysms of the descending thoracic aorta

Abstract: Excluded descending thoracic aortic aneurysms decrease in size on midterm follow-up. A subgroup of patients prone to neck dilatation might exist. A combination of neck dilatation and vector forces acting on stent-grafts in the tortuous thoracic aorta might lead to stent-graft migration.

Cited by 63 publications

References 19 publications

Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

Urgent thoracic aortal dissection and aneurysm: treatment with stent-graft implantation in an angiographic suite

Creation of individual ideally shaped stents using multi-slice CT: in vitro results from the semi-automatic virtual stent (SAVS) designer

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