Custom-made versus off-the-shelf multibranched endografts for endovascular repair of thoracoabdominal aortic aneurysms

Abstract

The t-branch device, with the unique advantage of direct implantation without any delay for manufacturing, showed 100% technical success and comparable clinical outcomes to the traditional custom-made mbEVARs. Further long-term evaluation remains mandatory.

Risk factors for spinal cord ischemia after endovascular repair of thoracoabdominal aortic aneurysms

“…1,3 Device characteristics and implantation. A custommade device (fenestrated, branched, or combined; Cook Medical Inc, Bloomington, Ind) was used for the elective cases.…”

“…1,2 The great expectation was that the minimally invasive character of the procedure (no visceral ischemia and no aortic clamping) would not only provide a survival benefit but also prevent spinal cord ischemia (SCI). However, the first series of TAAAs treated endovascularly could not support this hypothesis.…”

Early Results of Physician Modified Fenestrated Stent Grafts for the Treatment of Thoraco-abdominal Aortic Aneurysms

“…Preliminary series have provided good short-term results. Bisdas et al 2 recently reported their experience with custom made and off the shelf (t-branch) multibranched Cook devices. The t-branch device showed 100% technical success and similar clinical outcomes to the custom made device.…”

“…28,29 Therefore, some patients will still require custom made stent grafts. In their study, Bisdas et al 2 also identified the main obstacles that would make the t-branch unsuitable for implantation: distance between the celiac trunk and the most caudal renal artery >56 mm, insufficient luminal diameter (<25 mm) at the level of the visceral arteries, upward orientation of at least one renal artery, and a distance 67 mm between the most caudal renal artery and the aortic bifurcation. 2 Bisdas et al 2 also reported the availability of four target vessels accessible from an antegrade approach as being an anatomic inclusion criterion.…”

Application of Zenith t-Branch system in symptomatic thoracoabdominal aortic aneurysm with unfavourable anatomy — case report

“…The closure of the cuff is not mentioned in the IFU, however described in the literature by the application of "coils" [16]. Bisdas et al [17] compared results of the application CMD and t-Branch endograft in elective patients with TAAA. Although perioperative success was complete in both groups, mortality was higher in group treated with CMD (p = 0.04).…”