Revised duplex criteria and outcomes for renal stents and stent grafts following endovascular repair of juxtarenal and thoracoabdominal aneurysms

Mohabbat, Walid; Greenberg, Roy K.; Mastracci, Tara M.; Cury, Marcelo; Morales, Jose P.; Hernandez, Adrián V.

doi:10.1016/j.jvs.2008.11.024

Cited by 114 publications

(95 citation statements)

References 30 publications

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“…Extended basic anatomic criteria and technical issues for application of FEVAR with custom-made endografts are summarized in Table 2. 39,44,[54][55][56][57][58] Despite the use of fenestrations which are necessary to incorporate visceral vessels bearing the desired sealing zone, a segment of relatively normal suprarenal aorta that constitutes the proximal neck is still required in fenestrated grafts. Most authors have developed a practice of establishing proximal landing zones in a region of > 2 cm parallel-walled and thrombus-free aorta and of minimal tortuosity.…”

Section: Anatomical Criteriamentioning

confidence: 99%

“…42,57,63 The surgeon/interventionalist and his tools (armamentarium) and imaging facility (operating theatre environment) are important for the FEVAR procedure. Current developments in fixed X-ray platforms enable advanced intraoperative imaging options 55 No multiple or important accessory renal anatomy 44 (consider intentional coverage of small accessory branches if these contribute to < 25% of both kidneys or < 40% of one kidney) 55 No Excessive angulation (> 60°) poses the risk of SG malrotation/misalignment, making implantation more difficult and imperfect, adds strain into the visceral stents and may compromise the apposition between the SG fabric and the aortic wall. Furthermore, patients may be subjected to greater risk of stent fracture, dislodgment, and target vessel loss.…”

Section: Surgeon and Facility-based Criteriamentioning

confidence: 99%

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Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

et al. 2016

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The introduction of fenestrated stent grafts (SGs) to treat abdominal aortic aneurysms (AAAs) with short proximal necks began in 1999. Nowadays, the whole visceral aorta can be treated totally by endovascular means. The established use of fenestrated devices to treat complex AAAs as a first-line management option has been previously reported. An up-to-date evaluation of the literature was performed including all types of publications regarding the use of fenestrated technology to repair complex AAAs. Fenestrated repair is now an established alternative to hybrid/chimney/snorkel repairs. However, specific criteria and prerequisites are required for the use and improvement of this method. Multiple device morphologies have been used incorporating the visceral arteries in various combinations. This modular strategy connects different devices (bridging covered stents and bifurcated SGs) with the aortic main body, thus excluding the aneurysm from the circulation. Precise deployment of the fenestrated SG is mandatory for successful visceral vessel revascularization. Accurate SG sizing and customization, a high level of technical skill, and facilities with modern imaging techniques including 3D road mapping and dedicated hybrid rooms are required. Most experience has been with the custom-made Zenith Cook platform, although off-the-shelf devices have been recently implanted. More complex repairs have been performed over the last few years, but device complexity has also increased. Perioperative, mid-term, and a few recently reported long-term results are encouraging. Secondary interventions remain the main problem, similar to that observed after traditional endovascular abdominal aortic aneurysm repair (EVAR).

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Section: Anatomical Criteriamentioning

confidence: 99%

Section: Surgeon and Facility-based Criteriamentioning

confidence: 99%

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

et al. 2016

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“…Duplex ultrasound criteria applied were defined by Mohabbat et al 11 and MDCT scan interpretation was based on the methods described by Dowdall et al 12 Imaging outcomes were defined according to reporting standards 13 and to modifications assessed by Mastracci et al 5 Renal composite outcome included branch occlusion, in-stent stenosis, stent kinking, stent fracture, and renal related endoleak.…”

Section: Imaging Analysismentioning

confidence: 99%

Renal Outcomes Following Fenestrated and Branched Endografting

Martin-Gonzalez

Pinçon

Maurel

et al. 2015

European Journal of Vascular and Endovascular Surgery

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“…Customised devices include fenestrated and branch endografts, and the devices described herein are Cook Zenith customised endografts, which are commercially available and been previously described in the literature [8][9][10][11][12]. Of note, the long manufacturing lag time for these customised devices makes them unsuitable for emergency endografting.…”

Section: Customised Devicesmentioning

confidence: 99%

“…To this end, many new endovascular techniques and devices have emerged in recent years, developed primarily to overcome the issue of inadequate proximal landing zones, allowing endografting into previously unsuitable anatomies [8][9][10][11][12][13][14][15]. Among them, fenestrated and branch devices, as well as chimney and periscope techniques, are the most commonly used techniques.…”

Section: Introductionmentioning

confidence: 99%

Radiology of advanced EVAR techniques in complex abdominal aortic aneurysms

Pua

Tan

2011

Eur Radiol

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Advanced Endovascular Aortic Repair (EVAR) refers to devices and techniques used for endografting of aortic aneurysms that are considered anatomically unsuitable for conventional EVAR. Customised devices and modified use of conventional EVAR devices now overcome challenging landing zones. Fenestrated and branch devices, together with chimney and periscope techniques can be used to overcome proximal landing zone challenges, while iliac branch grafts and sandwich techniques have been used to address challenging distal iliac landing issues. Due to the novelty of these techniques, life-long surveillance is crucial, with CT Aortography (CTA) being the key investigation. Currently, the body of literature surrounding the imaging aspects of these techniques is scarce. The purpose of this imaging review is to illustrate the appearance of advanced EVAR in both routine surveillance and complicated cases, using conventional and novel CTA techniques. Key Points • This review updates readers about advanced endovascular repair of abdominal aortic aneurysms • It illustrates the common CT appearances following advanced EVAR • Novel CTA techniques in troubleshooting problems unique to advanced EVAR are described.

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Revised duplex criteria and outcomes for renal stents and stent grafts following endovascular repair of juxtarenal and thoracoabdominal aneurysms

Cited by 114 publications

References 30 publications

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

Renal Outcomes Following Fenestrated and Branched Endografting

Radiology of advanced EVAR techniques in complex abdominal aortic aneurysms

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