Performance of Bridging Stent-grafts in Fenestrated and Branched Aortic Endografting

Abstract

Introduction: Bridging stent-grafts (BSGs) are used to connect the target vessel with the main body during fenestrated or branched aortic endografting (f/bEVAR). At present, no dedicated device is available as BSG and different combinations of stent-grafts and relining stents have been proposed. Aims of this study were to assess the performance of the BSGs and to address potential risk factors for poor outcomes. Methods: Between 01/2010 and 03/2014, 150 consecutive patients underwent f/bEVAR and 515 target vessels were revascularized. Main measure outcome was any BSG-related complication. A logistic regression analysis including target vessel type, type of

Fenestrated and Branched Aortic Grafts

“…In a study from Münster reporting the findings in 150 fEVAR and bEVAR patients (523 target vessels, mean follow-up 1.2 years), 2% of stents in the visceral vessels were occluded and 4% required reintervention. The sole identified risk factor for complications was implantation of branched stent grafts (34).…”

Tortuosity is the Significant Predictive Factor for Renal Branch Occlusion after Branched Endovascular Aortic Aneurysm Repair

“…In this context, the recent study, which included the celiac artery and SMA in addition to renal artery branches, also failed to confirm the efficacy of the relining stents and the impact of multiple bridging stents. 18 Additionally, angulation of the distal renal artery, adopted as an indicator for distal kinking, was not a significant risk factor in the results. In the present study, the number of branches without lining stents might have been too small to detect the clinical effects in this limited follow up period.…”

“…Among them, four renal arteries in three patients underwent percutaneous thrombectomy combined with additional stenting, resulting in the successful secondary patency. 15,18 The primary patency rate was 88% and 84% at 1 and 2 years respectively and the secondary patency rate was 94% at 1 and 2 years. Table 3 shows the results of univariate analysis of patient characteristics, morphological factors of renal branches, and used stents associated with the risk of occlusion.…”

Balloon-Anchoring Technique to Stabilize Target Vessel Catheterization in Complex Endovascular Aortic Repair

“…7 The technical success rate of target vessel revascularization is around 99%; however, this impressive success rate is mostly from series in which the majority of the grafts used were custom-made. 8,9 Certain features of the target vessel, such as posterior location, upward-facing orientation, angulation, and ostial stenosis can compromise stable target vessel catheterization, and a bailout technique, such as the snare-ride technique, 3 is required.…”