Abstract
Endovascular aortic aneurysm repair with the EndurantTM stent-graft system has been shown to be safe and effective in high-risk surgical patients with complex suprarenal and/or infrarenal abdominal aortic aneurysm anatomy. The wireformed M-shaped stent architecture and proximal springs with anchoring pins theoretically permit optimal sealing in shorter and more angulated proximal aneurysm necks even under off-label conditions. Nonetheless, extremely difficult anatomical situations and inherent graft system-related limitations must be anticipated. Herein, we describe our techniques to overcome the capture of the tip sleeve within the suprarenal bare-stent anchoring pins, other endograft segments, and native vessels.
Highlights
Endovascular aortic aneurysm repair with the EndurantTM stent-graft system has been shown to be safe and effective in high-risk surgical patients with complex suprarenal and/ or infrarenal abdominal aortic aneurysm anatomy
Its success is dependent on specific anatomical parameters that include the abdominal aortic aneurysm (AAA) morphology and dimensions
Improvements in the endovascular stent-graft design, device delivery and deployment characteristics have all resulted in increased use of endovascular repair (EVAR) for straightforward cases but for those with more complex and challenging aneurysm anatomies
Summary
Scenario 1: Capture of the tip sleeve within the suprarenal bare-stent anchoring pins. The last option replaces the guide wire with a snare device that is introduced through a 7-, 12- or 14-Fr sheath via the left brachial artery access, and captures the spindle while simultaneously retracting the delivery system with slow rotational movements (Fig. 1C). In this situation the delivery system moved slightly upwards. It is not required to fully dilate the balloon up to 8 Atm since the purpose is just to freely remove the delivery system from the stenotic area In this scenario a guide wire, but even a sheath and later a balloon, can be inserted through the delivery system
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call