Percutaneous Placement of a Low-profile Stent-Graft Device for Aortic Dissections

Endovascular Management of Thoracic Dissections

“…Recently, in select patients, stent-graft procedures have been performed entirely percutaneously, with the puncture sites closed by commercially available suture-mediated access-closure devices. 52 The obvious benefits of this approach over surgical exposure are the decreased time to recovery and possible reduced risk of infection, lymphocele, seroma, and postoperative scar.…”

Percutaneous Thoracic and Abdominal Aortic Aneurysm Repair: Techniques and Outcomes

“…Some studies have successfully used the Preclose technique for endoluminal repair for abdominal aortic ruptures, thoracic and abdominal aortic dissections, traumatic thoracic aortic transactions, and repair of thoracic aneurysms, but the nature of disease in these patient populations and the acuity with which they present may make it hard to compare the groups and perform the same type of Percutaneous Thoracic and Abdominal Aortic Aneurysm Repair preoperative imaging, patient selection, and postoperative follow-up (see Table 1). 5,7,8,34 Conclusion A totally percutaneous approach to endoluminal treatment of aortic pathology has many advantages but requires good patient selection, technical expertise, a thorough understanding of the pitfalls of the device, and the ability to effectively troubleshoot or convert to an open procedure if needed. Using the Prostar XL Perclose device, complications are infrequent but can be significant, requiring complicated reintervention that can increase patient mortality.…”

“…4,5,20,24,29,30 The ranges are larger in the Percutaneous Thoracic and Abdominal Aortic Aneurysm Repair two-device group, with complications occurring in 0 to 12.7% and success rates of 66 to 100%. 7,8,10,17,22,27,28 Potential problems exist when using two devices. The needles of the second device can pierce the sutures of the first, causing deflection, suture breakage, or inability to capture in the barrel.…”

Percutaneous Modular Stent-Grafts in the Treatment of Abdominal Aortic Aneurysms

“…10 The sequential method of placing the components keeps the overall profile of the device small. Our initial experience with this modular nitinol stent-graft system was in the treatment of aortic dissection, 10 which showed promising results not unlike those reported later by Quinn et al 22 The same authors have also used a 14-F percutaneous bifurcated stent-graft delivery system that features sequential placement of an unsupported graft and a separate second stent. 23 Uflacker and Robinson 9 commented on the endovascular construction of a device using separate parts, particularly, a supporting skel-eton positioned after deployment of the graft.…”