Technical aspects and 30-day outcomes of the prospective early feasibility study of the GORE EXCLUDER Thoracoabdominal Branched Endoprosthesis (TAMBE) to treat pararenal and extent IV thoracoabdominal aortic aneurysms

Oderich, Gustavo S.; Farber, Mark A.; Silveira, Pierre Galvagni; Tadros, Rami O.; Marin, Michael L.; Fillinger, Mark F.; Makaroun, Michel S.; Hemmer, Jason D.; Madden, Meghan

doi:10.1016/j.jvs.2018.10.103

Cited by 72 publications

(31 citation statements)

References 16 publications

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“…19 It remains unknown if the lack of connections between the struts will prevent fracture and kinking and whether the design will maintain sufficient radial force to prevent distal branch-related endoleaks, and with the increased availability of aortic endografts, there is a need to develop dedicated technology for this specific area. 8,20 Panuccio et al 14 focused on the performance of each BSG using a per branch analysis. In their study, 19 reinterventions for different BSGs occurred in 12 patients.…”

Section: Discussionmentioning

confidence: 99%

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The Early Outcomes of BeGraft Peripheral Plus in Branched Endovascular Repair of Thoracoabdominal Aneurysms

et al. 2021

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Objective No bridging stent-graft (BSG) has been specifically designed for branched endovascular aortic repair (BEVAR) and therefore different “off-label” stent-grafts have been used. Recently, a third generation of balloon-expandable stent-graft has become available. Here we evaluate the outcomes of the BeGraft Peripheral Plus (B+) used as a BSG for internal/externalor inner branches during BEVAR. Materials and Methods Consecutive patients undergoing BEVAR using B+ as a BSG since its release in 2017 were included into the study. The primary endpoints were technical success and target vessel patency during follow-up. Secondary endpoints included the need for adjunct extension and relining of the BSG, branch instability rate, including occlusion, reinterventions for restonosis, kink, fracture, or endoleak (types 1 and 3). Results A total of 163 visceral branches in 46 patients were included with a median follow-up 15 months (4–36 months). Primary technical success was achieved in all visceral branches (69 inner branches and 94 internal/external branches) with the exception of 1 BSG that required serial dilatation until full expansion was achieved with overall branch patency was 98% at 2 years. An additional stent-graft was necessary in 35 branches (21%) following deployment of a B+ BSG to cover a longer bridging distance and optimize the distal and proximal sealing. Relining of B+ BSG was not routinely carried out during the index procedure and a self-expanding uncovered nitinol stent was necessary in only 3% of branches to smooth the distal transition zone between the BSG and target vessel. There were 4 events (2.4%) of branch related instability, including 2 occlusions and 2 late reinterventions for a partial in-stent-graft thrombosis. Conclusion Our study findings show satisfactory early outcomes of B+ as a BSG in BEVAR with low occlusion and reintervention rates. Extensions of BSG might be required to achieve adequate seal in the target vessels but routine relining BSG in branches was not required.

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Section: Discussionmentioning

confidence: 99%

“…5 Newer devices with preloaded inner branches are also in various stages of development. [6][7][8] Taken together, these will likely expand the use of this technology for treating patients with very complex aortic aneurysmal disease.…”

Section: Introductionmentioning

confidence: 99%

The Early Outcomes of BeGraft Peripheral Plus in Branched Endovascular Repair of Thoracoabdominal Aneurysms

et al. 2021

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“…In contrast, feasibility studies on the Gore TAMBE and the Cook Zenith p-Branch, a similar off-the-shelf device for juxtarenal, pararenal, and TAAA, noted eligibility rates of 48% and 33%, respectively. 14,15 This more inclusive study consisted of all patients diagnosed with unruptured TAAA, rather than only patients who were referred for surgical or endovascular treatment. By virtue of its inclusivity based on anatomic definitions, this study had the highest reported percentages of women and patients with TAAA due to dissection, groups that have been previously underrepresented in B-TEVAR anatomic suitability studies and clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Eligibility for Commercial Branched Endograft Repair of Thoracoabdominal Aortic Aneurysms

Edman

Bartek

Kang

et al. 2021

Annals of Vascular Surgery

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“…First, it is important to emphasize the increasing availability and encouraging results of off-the-shelf fenestrated/ branched stent-grafts, which many favor over patient-specific platforms. [6][7][8][9] A few proposed advantages of off-theshelf platforms include avoidance of the time delay for device manufacturing, standardization of planning and implantation technique, and the theoretical advantage in assembly of the devices by the industry. Nevertheless, the anatomical feasibility of off-the-shelf stent-grafts has been demonstrated to be quite limited, in part due to variations of renal and visceral anatomy.…”

Section: Endovascular Repair Of Abdominal Aortic Aneurysms (Evar)mentioning

confidence: 99%

Expanding the Anatomical Feasibility of Branched Stent-Grafts in Patients With Variant Visceral Vessel Anatomy

Mendes

Tenorio

2020

J Endovasc Ther

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Technical aspects and 30-day outcomes of the prospective early feasibility study of the GORE EXCLUDER Thoracoabdominal Branched Endoprosthesis (TAMBE) to treat pararenal and extent IV thoracoabdominal aortic aneurysms

Cited by 72 publications

References 16 publications

The Early Outcomes of BeGraft Peripheral Plus in Branched Endovascular Repair of Thoracoabdominal Aneurysms

The Early Outcomes of BeGraft Peripheral Plus in Branched Endovascular Repair of Thoracoabdominal Aneurysms

Anatomic Eligibility for Commercial Branched Endograft Repair of Thoracoabdominal Aortic Aneurysms

Expanding the Anatomical Feasibility of Branched Stent-Grafts in Patients With Variant Visceral Vessel Anatomy

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