First United States experience of the TX2 Pro-Form thoracic delivery system

Abstract

The Pro-Form delivery system significantly improves endograft conformation to the arch, resulting in minimum bird-beaking even in severely angulated anatomies.

Risk Factor Analysis of Bird Beak Occurrence after Thoracic Endovascular Aortic Repair

“…9 The Zenith Alpha stent grafts were not used because they were unavailable in the department. This low profile device is one of the newest endografts designed to overcome vascular access issues and also to improve conformability thanks to the new trigger wire release system.…”

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

“…95 The latter was designed specifically to achieve good proximal apposition due to a diameter reducing tie on the inner curve that forces the stent-graft to partially intussuscept, allowing a more angulated fixation. 94,95 Interestingly, although complete stent-graft apposition was significantly higher in the group that was treated with the Pro-Form delivery system (65% of Pro-Form patients vs 18% Z-Trak vs 6% Gore TAG, p<0.0001), there was no difference in terms of type Ia endoleak occurrence. 94 On the contrary, Ueda et al 89 demonstrated that mean birdbeak length was significantly longer in patients with type Ia or II endoleak (14.3 and 13.9 mm, respectively) than in patients without endoleaks (8.4 mm).…”

“…94,95 Interestingly, although complete stent-graft apposition was significantly higher in the group that was treated with the Pro-Form delivery system (65% of Pro-Form patients vs 18% Z-Trak vs 6% Gore TAG, p<0.0001), there was no difference in terms of type Ia endoleak occurrence. 94 On the contrary, Ueda et al 89 demonstrated that mean birdbeak length was significantly longer in patients with type Ia or II endoleak (14.3 and 13.9 mm, respectively) than in patients without endoleaks (8.4 mm). The bird-beak sign might be a precursor of an increased risk of rupture and therefore demands close follow-up.…”

“…This condition may lead to complications, such as endoleak, migration, collapse, and infolding, and is associated with both under- and oversizing. 77,89,94 The exact cause of a bird-beak formation remains speculative, although landing in zone 2 or 3 of the aortic arch seems to increase the risk. Also, a preoperative distal arch angle <151° has been described as a predictor of bird-beak configuration (sensitivity 86%, specificity 83%).…”

Commentary: New Low-Profile Zenith Alpha Stent-Graft for the Treatment of Thoracic Aortic Disease

“…15,16 However, this lower incidence of malalignment was not reflected in a decreased type I endoleak rate. The Zenith Alpha device is loaded on a precurved, triple axial deployment system, which should make the deployment easier and more accurate, potentially reducing misdeployment and malapposition.…”