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Clinical experience with a customized fenestrated endograft for juxtarenal abdominal aortic aneurysm repair

Uflacker, Renan ; Robison, Jacob D. ; Schonholz, Claudio and Ivancev, Krassi LU (2006) In Journal of Vascular and Interventional Radiology 17(12). p.1935-1942
Abstract
Despite the numerous stent-graft devices available, unsuitable anatomy is still the greatest exclusion criterion for endovascular abdominal aortic aneurysm (AAA) repair (EVAR). The present report describes an on-site preprocedural customization of a conventional Zenith stent-graft device just before the endovascular procedure that includes the creation of fenestrations and scallops as necessary for the patient's anatomy. Three patients with difficult anatomy in whom conventional AAA repair posed a high degree of risk were treated with customization of the stent-graft device to fit disparate renal arteries. A single fenestration for the left renal artery was made in two cases, and a single scallop was made in the other case to accommodate... (More)
Despite the numerous stent-graft devices available, unsuitable anatomy is still the greatest exclusion criterion for endovascular abdominal aortic aneurysm (AAA) repair (EVAR). The present report describes an on-site preprocedural customization of a conventional Zenith stent-graft device just before the endovascular procedure that includes the creation of fenestrations and scallops as necessary for the patient's anatomy. Three patients with difficult anatomy in whom conventional AAA repair posed a high degree of risk were treated with customization of the stent-graft device to fit disparate renal arteries. A single fenestration for the left renal artery was made in two cases, and a single scallop was made in the other case to accommodate the superior mesenteric artery. Gold beads were used to mark the location of the fenestration and scallop. The three cases were successfully performed without perceptible endoleaks in the follow-up period, which ranged from 4 to 14 months. No procedure-related complications were detected; however, pneumonia developed in one patient 3 weeks after EVAR. The initial results with this technique are encouraging, and the role of EVAR can be significantly increased with the use of this customization technique when the interventionalist does not have access to the commercially available devices or when the waiting time is too prolonged to accommodate the patient's clinical situation. (Less)
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author
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publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Vascular and Interventional Radiology
volume
17
issue
12
pages
1935 - 1942
publisher
Society of Interventional Radiology
external identifiers
  • wos:000243281500009
  • scopus:33847652894
ISSN
1051-0443
DOI
10.1097/01.RVI.0000248828.92093.1A
language
English
LU publication?
yes
id
7795cec8-6634-4055-9908-e5be0ef8742a (old id 679287)
date added to LUP
2016-04-01 17:06:37
date last changed
2021-06-01 03:14:12
@article{7795cec8-6634-4055-9908-e5be0ef8742a,
  abstract     = {Despite the numerous stent-graft devices available, unsuitable anatomy is still the greatest exclusion criterion for endovascular abdominal aortic aneurysm (AAA) repair (EVAR). The present report describes an on-site preprocedural customization of a conventional Zenith stent-graft device just before the endovascular procedure that includes the creation of fenestrations and scallops as necessary for the patient's anatomy. Three patients with difficult anatomy in whom conventional AAA repair posed a high degree of risk were treated with customization of the stent-graft device to fit disparate renal arteries. A single fenestration for the left renal artery was made in two cases, and a single scallop was made in the other case to accommodate the superior mesenteric artery. Gold beads were used to mark the location of the fenestration and scallop. The three cases were successfully performed without perceptible endoleaks in the follow-up period, which ranged from 4 to 14 months. No procedure-related complications were detected; however, pneumonia developed in one patient 3 weeks after EVAR. The initial results with this technique are encouraging, and the role of EVAR can be significantly increased with the use of this customization technique when the interventionalist does not have access to the commercially available devices or when the waiting time is too prolonged to accommodate the patient's clinical situation.},
  author       = {Uflacker, Renan and Robison, Jacob D. and Schonholz, Claudio and Ivancev, Krassi},
  issn         = {1051-0443},
  language     = {eng},
  number       = {12},
  pages        = {1935--1942},
  publisher    = {Society of Interventional Radiology},
  series       = {Journal of Vascular and Interventional Radiology},
  title        = {Clinical experience with a customized fenestrated endograft for juxtarenal abdominal aortic aneurysm repair},
  url          = {http://dx.doi.org/10.1097/01.RVI.0000248828.92093.1A},
  doi          = {10.1097/01.RVI.0000248828.92093.1A},
  volume       = {17},
  year         = {2006},
}