Improvement in conformability of the latest generation of thoracic stent grafts

Canaud, Ludovic; Cathala, Philipe; Joyeux, Frédéric; Branchereau, Pascal; Marty-Ané, Charles; Alric, Pierre

doi:10.1016/j.jvs.2012.09.019

Cited by 28 publications

(17 citation statements)

References 8 publications

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“…However, the enhanced conformability of the last generation of thoracic stent-graft has significantly decreased the rate of stent-graft collapse. 23,24 Several therapeutic options can be proposed: the stentgraft can either be removed via an open thoracotomy or be re-expanded by an endoluminal approach. Open repair should be considered in cases of severely collapsed stent graft and/or deemed at high risk of coverage of supra-aortic trunks owing to a severely angulated aortic arch.…”

Section: Discussionmentioning

confidence: 99%

Open Surgical Secondary Procedures after Thoracic Endovascular Aortic Repair

Canaud

Alric

Gandet

et al. 2013

European Journal of Vascular and Endovascular Surgery

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Complications or prevention of complications after TEVAR either due to device failure or adverse events may require conversion to open repair or additional open surgical procedure. Open repair can be performed by a team experienced in management of diseases of the thoracic aorta and a low mortality rate achieved despite the precarious preoperative conditions and complex aortic pathologies of patients.

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Section: Discussionmentioning

confidence: 99%

Open Surgical Secondary Procedures after Thoracic Endovascular Aortic Repair

Canaud

Alric

Gandet

et al. 2013

European Journal of Vascular and Endovascular Surgery

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“…Experimental and clinical data have shown that poor endograft apposition within the aortic arch increases the risk of technical failure after TEVAR [ 6 – 8 ]. The requirement for enhanced conformability has influenced the design of next-generation devices [ 9 ]. In November 2009, the Conformable TAG Thoracic Endoprosthesis (CTAG; W. L. Gore & Associates, Inc., Flagstaff, USA) received CE mark approval for TEVAR in Europe.…”

Section: Introductionmentioning

confidence: 99%

Device Conformability and Morphological Assessment After TEVAR for Aortic Type B Dissection: A Single-Centre Experience with a Conformable Thoracic Stent-Graft Design

Bischoff

Müller–Eschner

Meisenbacher

et al. 2015

Med Sci Monit Basic Res

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BackgroundThe aim of this study was to analyze device conformability in TEVAR of acute and chronic (a/c) type B aortic dissections (TBAD) using the Gore Conformable Thoracic Aortic Stent-graft (CTAG).Material/MethodsFrom January 1997 to February 2014, a total of 90 out of 405 patients in our center received TEVAR for TBAD. Since November 2009, 23 patients (16 men; median age: 62 years) were treated with the CTAG. Indications were complicated aTBAD in 15 (65%) and expanding cTBAD in 8 (35%) patients. Primary endpoints were the assessment of device conformability by measuring the distance (D) from the radiopaque gold band marker (GM) at the proximal CTAG end to the inner curvature (IC) of the arch on parasagittal multiplanar reformations of CT angiography, as well as the evaluation of aortic diameter changes following TEVAR. Median follow-up was 13.3 months (range: 2 days to 35 months).ResultsPrimary and secondary success rates were 91.3% (21/23) and 95.6% (22/23), respectively. There was 1 type Ia endoleak, retrograde dissection or primary conversion was not observed. Median GM-IC-D was 0 mm (range: 0 mm to 10 mm). GM-IC-D was associated with zone 2 placement compared to zone 3 (P=0.036). There was no association between GM-IC-D formation and arch type. In aTBAD cases the true lumen significantly increased after TEVAR (P=0.017) and the false lumen underwent shrinkage (P=0.025). In cTBAD patients the false lumen decreased after TEVAR (P=0.036).ConclusionsThe CTAG shows favorable conformability and wall apposition in challenging arch pathologies such as TBAD.

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“…5 The angle between the inner curvature of the aortic arch and the stent graft depends on the stent graft, the patient's age, and the cardiac phase. 6,7 Younger people often present with a tighter so-called gothic arch in contrast to the wider aortic arch to normally found in older people. Variation of the angle over the cardiac cycle has been reported as high as 20 (minimum in the diastole and maximum in the systole), 8 likely causing the risk of a stent graft compression syndrome with subsequent high aortic occlusion.…”

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confidence: 99%