Use of the Gore Hybrid Vascular Graft in a challenging high-lying extracranial carotid artery aneurysm

Nigro, Gianluigi; Gatta, Emanuele; Pagliariccio, Gabriele; Grilli, Carlo; Carbonari, Luciano

doi:10.1016/j.jvs.2013.04.044

Cited by 19 publications

(16 citation statements)

References 16 publications

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“…In addition, covered stent was not an option for a kinked ICA with an aneurysm because of the difficulty of endovascular approach and high embolization risk. Nigro et al [25] suggested a hybrid technique with a more favorable outcome, which consisted of surgical shortening of the proximal ICA to adjust the kinking followed by stent placement. This technique was also used in 1 case of our series.…”

Section: Discussionmentioning

confidence: 99%

Endovascular stenting for extracranial carotid artery aneurysms

Zeng

et al. 2016

Medicine

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The aim of this study was to investigate the safety and effectiveness of endovascular stenting for extracranial carotid artery aneurysms (ECAAs) and evaluate the mid-term outcomes.Twelve consecutive symptomatic patients (mean age 43.8 ± 14.9 years; 8 men) with ECAAs who were treated with endovascular stenting between 1997 and 2015 were retrospectively analyzed. Clinical follow-up data including symptoms and neurological events were obtained from outpatient records. Imaging follow-up with duplex ultrasound and/or computed tomographic angiography (CTA) was performed to examine the aneurysm obliteration and patency of the stents at 3, 6, 12 months and yearly thereafter.A total of 5 true aneurysms and 7 pseudoaneurysms were included in our series. Neurological symptoms (n = 5, 41.7%) and a pulsatile neck mass (n = 5, 41.7%) were the most common presenting symptoms. Endovascular stenting procedures were technically successful in all cases; 3 patients received bare stents, and 9 patients received covered stents. No perioperative neurologic or cardiopulmonary complications occurred. Over a period of follow-ups (mean 21.8 ± 25.1 months), all patients were alive and free from neurological or other adverse events. All aneurysms were completely excluded except for 1 patient who was exposed to a residual medium leaking into the aneurysm sac. No reintervention was performed in this specific patient because aneurysm growth or significant clinical symptoms did not occur. Recurrent restenosis assessed by CTA imaging at 12 months occurred in 1 (8.3%) patient in our series. Target lesion revascularization for this hemodynamic restenosis was treated with placement of an additional stent.In our series, endovascular stenting for ECAAs was found to be safe, effective, and proved to have promising mid-term results. Although long-term results need to be further explored, advantages including less procedure-related complications and a shorter recovery time make endovascular stenting an attractive option for ECAAs, especially for the patients who are unfit for traditional open surgery.

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Section: Discussionmentioning

confidence: 99%

Endovascular stenting for extracranial carotid artery aneurysms

Zeng

et al. 2016

Medicine

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“…Possibly, the lack of a suitable conical stent could have been dealt with by releasing multiple covered stents with gradually increasing calibers overlapping each other, using tapered stent-grafts. [11][12][13][14][15][16] However, the long-term efficacy of this endovascular option is lacking evidence from studies, especially in the topography of the knee joint. Furthermore, endovascular surgery is not available at the service where this patient was treated.…”

Section: Discussionmentioning

confidence: 99%

Correção cirúrgica de pseudoaneurismas e fístula arteriovenosa complexa entre vasos poplíteos

et al. 2018

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Resumo A fístula arteriovenosa (FAV) é uma comunicação anormal e permanente entre uma artéria e uma veia devido a traumas penetrantes e lesões iatrogênicas. O trauma penetrante na parede arterial pode levar à formação de pseudoaneurismas (PSA) e, se houver lesão venosa concomitante, à formação de uma FAV. Os autores apresentam o caso de um paciente portador de FAV complexa de vasos poplíteos associada a pseudoaneurisma de artéria poplítea, sugeridos a partir de exames clínicos e exames de imagem, e tratados por cirurgia convencional devido à indisponibilidade de um stent graft com diâmetro apropriado, além de a cirurgia endovascular não estar disponível no serviço em que o paciente foi operado.

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“…[26][27][28] The first large experience with the use of GHVG was recently reported by Chiesa et al 29 to address RAs during open TAAA repair. Their experience with 25 patients reported satisfactory results that are at least comparable to those of standard renal revascularization.…”

Section: Discussionmentioning

confidence: 99%

The Gore Hybrid Vascular Graft in renovisceral debranching for complex aortic aneurysm repair

Setacci

Pecoraro

Chaykovska

et al. 2016

Journal of Vascular Surgery

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we analyzed outcomes of 13 patients who underwent open surgical debranching of renovisceral vessels for thoracoabdominal aortic aneurysm and PAAAs. All patients were considered at high risk for conventional surgery. Inclusion criterion was treatment by open surgical debranching of at least one visceral artery (renal artery, superior mesenteric artery [SMA], or celiac trunk [CT]) using the GHVG. In a second step, the aortic stent graft was implanted to exclude the aneurysm. If required, parallel grafts to the remaining visceral arteries were deployed in the same procedure. One patient had a symptomatic descending thoracic aortic aneurysm and another had a ruptured PAAA. Perioperative measured outcomes were immediate technical success rate, mortality, and morbidity. Median follow-up was 24.8 months (range, 0-15; mean, 8.2; standard deviation, 4 months).Results: All open surgical debranching of renovisceral vessels were completed as intended. GHVG was used to revascularize 20 visceral vessels in 13 patients with a mean of 1.54 vessels per patient. Six renal arteries (30%; 2 right and 4 left), 9 SMAs (45%), and 5 CTs (25%) were debranched. In nine of 13 (66%) patients, other renovisceral arteries were addressed with chimney/periscope, Viabahn Open Revascularization Technique, and end-to-side anastomosis. Two of 13 patients (15%) died of bowel ischemia. Neither patient had GHVG revascularization to the SMA or CT. Perioperative complications occurred in three patients (23%; 1 renal hematoma, 1 respiratory insufficiency, and 1 small-bowel ischemia related to a SMA GHVG thrombosis). At 24 months, estimated survival was 85%, and estimated primary and secondary patency were 94% and 100%, respectively. Conclusions: This limited series extracted from a more consistent hybrid procedure experience showed a mortality rate similar to most recent reports. Technical feasibility and the short-term patency rate of the GHVG for renovisceral debranching during staged hybrid open and endovascular procedures were satisfactory. Use of GHVGs may represent a useful revascularization adjunct to minimize visceral ischemia in these challenging patients. (J Vasc Surg 2016;64:33-8.)

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Use of the Gore Hybrid Vascular Graft in a challenging high-lying extracranial carotid artery aneurysm

Cited by 19 publications

References 16 publications

Endovascular stenting for extracranial carotid artery aneurysms

Endovascular stenting for extracranial carotid artery aneurysms

Correção cirúrgica de pseudoaneurismas e fístula arteriovenosa complexa entre vasos poplíteos

The Gore Hybrid Vascular Graft in renovisceral debranching for complex aortic aneurysm repair

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