Surgeon-modified fenestrated stent graft deployment in type B aortic dissection

İşcan, Hakkı Zafer; Ünal, Ertekin Utku

doi:10.5606/tgkdc.dergisi.2021.20641

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…One patient was lost on the postoperative third day due to malperfusion, the other patient was discharged without any complication. The SMFSG technique is our preferred method of treatment, and it is carried out on anatomically appropriate patients to maintain LSA endovascular patency while landing at zone 2 [11,25]. Ten fenestrated stent grafts were successfully implanted since 2020 and they were all patent in the mid-term follow-up period.…”

Section: Discussionmentioning

confidence: 99%

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Early and mid-term results of endovascular repair for type B aortic dissections: A single tertiary center experience

Yigit,

Deniz,

Hasanzade

et al. 2023

Turk J Vasc Surg

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Aim: The utility of thoracic endovascular aortic repair (TEVAR) in Type B Aortic dissections (TBAD) continues to advance at a growing rate. The purpose of this research was to investigate our management strategy and early-mid-term outcomes of endovascular procedures for TBAD, in a single tertiary center. Material and Methods: Sixty-six eligible TBAD patients (2 hyperacute complicated, 12 acute complicated and 52 uncomplicated) were enrolled in this single-center, retrospective cohort study between January 2016 and January 2023. The endpoints of the study were technical success, early and late morbidity and mortality, reinterventions throughout the follow-up period, as well as late open conversion. Results: Technical success was achieved in all cases. Early mortality was seen in only 3 patients (4.5%). Only patients with one hyperacute and two acute complicated TBAD (cTBAD) had early death. There was one late mortality in an acute cTBAD patient, who developed retrograde type A dissection two months after TEVAR. The median follow-up period was 26.1±13.7 months. Six reinterventions were performed for extension of dissection or covering the entries distally (9.1%). No endoleak, graft infection or migration were observed. Open surgical repair was performed; however, the patient did not survive. Conclusion: Early results of TEVAR in elective TBAD is trouble-free. Carrying the patients to the subacute phase seems to be the most suitable timing for TEVAR. Anti-stimulus and anti-hypertensive treatment with surveillance programme is mandatory for this patient cohort. Pre-emptive TEVAR has satisfactory results; however, long-term results are mandatory for further recommendations.

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Section: Discussionmentioning

confidence: 99%

“…Previously published research has described the surgeon-modified fenestrated stent graft (SMFSG) technique [11]. The stent graft was unsheathed to approximately 4-5 cm for fenestration after the initial angiography of the aortic arch.…”

Section: Smfsg Proceduresmentioning

confidence: 99%

Early and mid-term results of endovascular repair for type B aortic dissections: A single tertiary center experience

Yigit,

Deniz,

Hasanzade

et al. 2023

Turk J Vasc Surg

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“…Our first case was for Zone 2 left subclavian artery (LSA) endo-revascularization with back table fenestration nearly two years ago for subacute type B aortic dissection and was the first documented SMFSG for LSA in Türkiye. [7] For a successful procedure, the surgeon must be accustomed to the endograft used. Every brand may be used for this purpose; however, we preferred the Ankura™ TAA Stent Graft owing to its conformity.…”

Section: (A) (B) (C)mentioning

confidence: 99%

Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus

İşcan

Tümer

Mavioğlu

2023

Turk Gogus Kalp Dama

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Currently, thoracic endovascular aortic repair is usually the first-line treatment option for descending aortic pathologies. Supra-aortic or visceral branches sometimes involve assistive thoracic endovascular aortic repair techniques; hybrid procedures or intentional coverage may be performed during the procedure to achieve a sufficient proximal or distal landing zone. Most surgeons may agree on selective coverage of celiac truncus, but revascularization is preferred to reduce the risk of ischemic complications. Herein, we present the first successful surgeonmodified fenestrated stent graft procedure for celiac truncus in a patient with Crawford type V descending aortic aneurysm in Türkiye.

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“…For Surgeon Modified Fenestrated Stent Graft (SMFSG), we specifically preferred this endograft, as there are two different shaped radiopaque markers "8" and "0" on each proximal side, facilitating the orientation and positioning [5].…”

Section: Surgical Techniquementioning

confidence: 99%

Early and midterm outcomes of thoracic endovascular aortic repair with Lifetech Ankura™ thoracic endograft: A single tertiary center experience

Hasanzade,

Ergin,

Gevrek

et al. 2023

Turk J Vasc Surg

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Aim: Thoracic aortic pathologies describe a wide spectrum of potentially life-threatening diseases almost always in a comorbid aged patient cohort. Thoracic endovascular aortic repair (TEVAR) is a less invasive treatment choice, offering reduced mortality and morbidity compared to open surgery. We decided to reveal our experience over safety and efficacy data with Lifetech Ankura™ Thoracic endografts with early and midterm outcomes, retrospectivelytiology. Material and Methods: Between January 2018 and January 2023, for a 5-year period, 203 patients who experienced TEVAR procedure with Lifetech Ankura™ Thoracic endograft were retrospectively evaluated. For the patients who required revascularization of the vessel branches originating from the aortic segments, all types of assistive techniques were performed. Intentional coverage of Left subclavian artery was also performed mostly in urgent patients. Results: 251 endografts were implanted in 203 patients. The most frequent aortic pathologies were the thoracic aortic fusiform aneurysm (56.6%) and type B aortic dissection (25.6%), respectively. Early (30-day/in-hospital) mortality occurred in 9 patients in total (4.4%). Technical success rate was 100%, and there was no conversion to open surgery. No other major adverse event, including cerebral, cardiac, or renal complication requiring dialysis, was observed. The average intensive care unit time was 16.9±11 hours (2-160), length of stay was 5.1±3.2 days. CSF drainage was performed in 51 patients inserted before the procedure prophylactically (25.1%). All patients who survived the operation were followed for 18.6±9.3 months. In the follow up period, four patients needed extension for endoleaks and two additive petticoat procedures were performed. One patient who had TEVAR due to a malperfused type B aortic dissection in the acute phase experienced RTAD 2 weeks after the initial procedure. Conclusion: TEVAR with LifeTech Ankura™ Thoracic Stent Graft system provides a safe, effective, and durable treatment with successful early outcomes and technical success. Wide spectrum in length and non-identical radiopaque proximal markers seem to facilitate some advanced endovascular skills. Long-term durability of the endograft should be tested.

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Surgeon-modified fenestrated stent graft deployment in type B aortic dissection

Cited by 6 publications

References 6 publications

Early and mid-term results of endovascular repair for type B aortic dissections: A single tertiary center experience

Early and mid-term results of endovascular repair for type B aortic dissections: A single tertiary center experience

Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus

Early and midterm outcomes of thoracic endovascular aortic repair with Lifetech Ankura™ thoracic endograft: A single tertiary center experience

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