Prospective, nonrandomized study to evaluate endovascular repair of pararenal and thoracoabdominal aortic aneurysms using fenestrated-branched endografts based on supraceliac sealing zones

Abstract

Endovascular repair of pararenal aortic aneurysms and TAAAs, using manufactured F-BEVAR with supraceliac sealing zones, is safe and efficacious. Long-term follow-up is needed to assess the impact of four-vessel designs on device-related complications and progression of aortic disease.

One Year Outcomes of 101 BeGraft Stent Grafts used as Bridging Stents in Fenestrated Endovascular Repairs

“…Type 3 endoleaks, described by Mastracci et al as endoleaks from bridging stent disconnection to the fenestration or disconnection between two bridging stents, 5 are reported to be the major cause of re-intervention following complex endovascular repair. 22 In practice with this new generation stent, flaring is very efficient, and the present authors have not observed any type 3 endoleaks. The aortic portion of the stent, which is very well visualised (cobaltchromium alloy offers an opacity that allows accurate positioning during deployment) during the procedure, conformed very well to the 10 mm diameter flaring balloon, and provided a durable seal at the connexion with the nitinol reinforced fenestrations.…”

Intraoperative adverse events and early outcomes of custom-made fenestrated stent grafts and physician-modified stent grafts for complex aortic aneurysms

“…Because this patient had a single iliac access available and we were concerned about successful renal cannulation through fenestrations and previously placed bare-metal stent in an angulated visceral aorta, we decided to treat him using a modified closed web Valiant device with one fenestration for (14) Peripheral artery disease 5 (7) 7 (25) .03 12 (12) History of aortic surgery 9 (13) 7 (25) . 22 16 (16) ASA class the superior mesenteric artery that was cannulated from an axillary access and two chimney grafts for renal arteries.…”

“…Regarding the treatment of CAAAs by CMSGs, our 4% inhospital mortality rate is in line with previous reports from high-volume centers. [21][22][23][24][25] Compared with our initial results, 26 short-term outcomes improved significantly with larger experience. Of the three deaths in the CMSG group, two occurred in our early experience in patients with shaggy aortas, which are currently considered strict contraindications to fenestrated stent grafts.…”

“…In-hospital mortality and complication rates reported in the CMSG group for the treatment of TAAAs were also comparable to those previously reported in the literature. 22,[27][28][29][30] With growing experience, technical adjustments for graft modifications were done to reduce the risks of cannulation problems and endoleak. For asymptomatic large aneurysms, fenestrations are created in custom-made devices, which can be provided within 5 days with specific proximal and distal diameters, with a specific level of tapering, and without proximal barbs.…”

Severe infolding of fenestrated-branched endovascular stent graft

“…Fenestrated and branched endografts have broadened the indications of endovascular aortic repair to patients with complex aneurysms involving the renal and mesenteric arteries 4, 5. In most centers with larger experience, fenestrated stent grafts have evolved from two fenestrations to three or four fenestrations based on supraceliac sealing zones.…”