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In situ bending of thoracic stent grafts: Clinical application of a novel technique to improve conformance to the aortic arch.

Kölbel, Tilo LU ; Dias, Nuno LU ; Resch, Tim LU ; Holst, Jan LU ; Sonesson, Björn LU and Malina, Martin LU (2009) In Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 49. p.1613-1616
Abstract
PURPOSE: A straight thoracic stent graft often complies poorly with the curvature of the aortic arch. We have previously reported an in vitro model of a modified stent graft that can be bent in situ after deployment to improve conformance to the aortic arch. We now report the first clinical experience with this technique in three consecutive patients. METHODS: Between September 2007 and August 2008, three patients were treated for different pathologies of the aortic arch with a modified thoracic stent graft that was fitted with a sliding self-locking knot and a detachable Bowden cable. Transfemoral traction on the Bowden cable enables controlled shortening of the proximal part of the stent graft at the inner curve after deployment. The... (More)
PURPOSE: A straight thoracic stent graft often complies poorly with the curvature of the aortic arch. We have previously reported an in vitro model of a modified stent graft that can be bent in situ after deployment to improve conformance to the aortic arch. We now report the first clinical experience with this technique in three consecutive patients. METHODS: Between September 2007 and August 2008, three patients were treated for different pathologies of the aortic arch with a modified thoracic stent graft that was fitted with a sliding self-locking knot and a detachable Bowden cable. Transfemoral traction on the Bowden cable enables controlled shortening of the proximal part of the stent graft at the inner curve after deployment. The stent graft is thereby directed to allow for better apposition to the aortic wall. RESULTS: The modified thoracic stent grafts were correctly orientated and deployed in all patients. Transfemoral traction on the Bowden cable successfully bent all stent grafts and improved vessel wall apposition without a residual gap on the inner curve. The Bowden cable was successfully released and withdrawn in all patients. CONCLUSION: In situ bending of thoracic stent grafts with a sliding self-locking knot is feasible and improves proximal apposition of the device at the inner curve of the aortic arch. More data and longer follow-up are required to confirm the applicability of this technique. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
volume
49
pages
1613 - 1616
publisher
Mosby
external identifiers
  • WOS:000266681000038
  • PMID:19307087
  • Scopus:67349137709
ISSN
1097-6809
DOI
10.1016/j.jvs.2008.12.014
language
English
LU publication?
yes
id
1fe96ef6-4bef-44dc-8e4c-096a7621a694 (old id 1367547)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19307087?dopt=Abstract
date added to LUP
2009-04-07 15:38:58
date last changed
2016-10-13 04:30:25
@misc{1fe96ef6-4bef-44dc-8e4c-096a7621a694,
  abstract     = {PURPOSE: A straight thoracic stent graft often complies poorly with the curvature of the aortic arch. We have previously reported an in vitro model of a modified stent graft that can be bent in situ after deployment to improve conformance to the aortic arch. We now report the first clinical experience with this technique in three consecutive patients. METHODS: Between September 2007 and August 2008, three patients were treated for different pathologies of the aortic arch with a modified thoracic stent graft that was fitted with a sliding self-locking knot and a detachable Bowden cable. Transfemoral traction on the Bowden cable enables controlled shortening of the proximal part of the stent graft at the inner curve after deployment. The stent graft is thereby directed to allow for better apposition to the aortic wall. RESULTS: The modified thoracic stent grafts were correctly orientated and deployed in all patients. Transfemoral traction on the Bowden cable successfully bent all stent grafts and improved vessel wall apposition without a residual gap on the inner curve. The Bowden cable was successfully released and withdrawn in all patients. CONCLUSION: In situ bending of thoracic stent grafts with a sliding self-locking knot is feasible and improves proximal apposition of the device at the inner curve of the aortic arch. More data and longer follow-up are required to confirm the applicability of this technique.},
  author       = {Kölbel, Tilo and Dias, Nuno and Resch, Tim and Holst, Jan and Sonesson, Björn and Malina, Martin},
  issn         = {1097-6809},
  language     = {eng},
  pages        = {1613--1616},
  publisher    = {ARRAY(0x91bf770)},
  series       = {Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter},
  title        = {In situ bending of thoracic stent grafts: Clinical application of a novel technique to improve conformance to the aortic arch.},
  url          = {http://dx.doi.org/10.1016/j.jvs.2008.12.014},
  volume       = {49},
  year         = {2009},
}