Efficacy and durability of endovascular thoracoabdominal aortic aneurysm repair using the caudally directed cuff technique

Abstract

Total endovascular TAAA/PRAA repair using caudally directed cuffs is safe, effective, and durable in the intermediate term. The most common form of late failure, renal artery occlusion, rarely had a clinically significant consequence (dialysis). The trend toward worse outcome in women needs further study.

Performance of Bridging Stent Grafts in Fenestrated and Branched Aortic Endografting

“…Reilly et al also performed a per vessel analysis. 13 They reported a primary patency of 94.8% but this rate was not related to time and cannot be compared with the patency rate in the current study, which was based on KaplaneMeier analysis.…”

“…However, this scenario requires further investigation. In the experience reported by Reilly et al 13 using mostly self expandable BSGs, 11 occlusions and five BSG stenoses (5%) were observed; none of them was related to kinking or BSG collapse. No other occlusion mechanism was suggested but, interestingly they encountered a higher rate of vessel injuries (14 of 306; 5%) and two of them led to occlusions.…”

“…However, Reilly et al used an AMB containing four internal/external cuffs, which was axially oriented and caudally directed, in 23 patients, representing 28% of their study cohort. 13 In contrast, Mastracci et al strongly suggest fenestrations only for renal arteries, 12 and they could not find any risk factor for branch instability. However, they focused more on patient and aneurysm related risk factors (demographic characteristics and aneurysm type) and not on the influence of materials.…”

“…Reilly et al also reported similar findings. 13 However, in the long term, the type of target vessel no longer represents a significant risk factor. In the current series, 12 events were related to the SMA and CT (5%), and in two patients the SMA occlusions were established postmortem as cause of death.…”

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

“…75 For example, the combination of fenestrations and branches in the same proximal SG component has been used in narrow or angulated reno-visceral aortic segments, 86 or internal/external cuffs (axially oriented or caudally directed) for TAAAs and PRAs. 87 Moreover, to overcome the necessity of aortic main body customization, off-the-shelf devices have become apparent. These are fixed SG configurations, depending on the manufacturer, developed to accommodate in a wide range of aortic anatomies owing to the fact that recurrent patterns of similar arterial morphologies exist.…”