Experience with the sandwich technique in endovascular thoracoabdominal aortic aneurysm repair

Schwierz, Elisabeth; Kolvenbach, Ralf; Yoshida, Ricardo de Alvarenga; Yoshida, Winston Bonetti; Alpaslan, Alper; Karmeli, Ron

doi:10.1016/j.jvs.2013.12.044

Cited by 45 publications

(29 citation statements)

References 21 publications

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“…7 However, CSGs have long manufacturing times and are therefore inappropriate for symptomatic and ruptured TAAAs. Hybrid 8 and exclusively endovascular 9 procedures have been offered in urgent/emergent settings, but these techniques are burdened by high morbidity rates (around 35%) [9][10][11] and overall perioperative mortality (13%). 8 Sweet et al 12 in 2009 demonstrated that a "standardized" endograft could be applied to 88% of aortic shapes.…”

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confidence: 99%

Standard “off-the-shelf” multibranched thoracoabdominal endograft in urgent and elective patients with single and staged procedures in a multicenter experience

Silingardi

Gennai

Leone

et al. 2018

Journal of Vascular Surgery

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confidence: 99%

Standard “off-the-shelf” multibranched thoracoabdominal endograft in urgent and elective patients with single and staged procedures in a multicenter experience

Silingardi

Gennai

Leone

et al. 2018

Journal of Vascular Surgery

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“…Also, these devices are not available in many centers in developing countries. Alternative "off the shelf " endovascular techniques, like parallel graft techniques and physician-modified fenestrated stent-grafts, involve the use of standard grafts with good short-term and mid-term results [9][10][11][12][13][14][15]. Considering the anatomy of our case, we deemed that the diameter and shape of the true lumen were inadequate to accommodate two chimney grafts for the CT and the SMA.…”

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confidence: 96%

A case report of a hybrid procedure (visceral and partial aortic arch debranching) in the treatment of a challenging aneurysm of the thoracoabdominal aorta in the endovascular era

et al. 2020

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Introduction This paper aimed to present a hybrid approach as a less invasive and acceptable treatment. Case outline Because of respiratory failure, the patient was deemed at high risk for open repair. Standard thoracic endovascular aortic repair (TEVAR) was unfeasible, so the patient underwent the hybrid procedure-partial aortic arch debranching at the first stage, followed by visceral debranching and endovascular exclusion of thoracic aortic aneurysm as a final procedure. The postoperative course was uneventful and the patient was discharged 10 days after TEVAR and visceral debranching. Conclusion Staged hybrid procedure with combined debranching of the aortic arch and visceral arteries is feasible and should be considered as an alternative treatment option in patients with high-risk for open repair.

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“…72 Recent reports showed that the technical success and 30-day mortality rates were 88 and 6.3%, respectively, and endoleaks and risk of visceral stent occlusion were more frequent as the number of chimney grafts increased. 73 TEVAR with CA coverage indicated for Crawford type I TAAA cases is safe and effective when the CA-SMA collateral circulation is present. Technical success was acceptable, but the 30-day mortality was 9.7% in a recent review, and the most common cause of death was visceral ischemia, which accounted for 30% of such cases.…”

Section: Thoracoabdominal Aortic Aneurysmmentioning

confidence: 99%

Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies

2018

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The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms. However, its indication has expanded along with the improvement of techniques and devices, and currently, it has become possible to treat pararenal aortic aneurysms and Crawford type 4 thoracoabdominal aortic aneurysm (TAAA) using the off-the-shelf devices. Additionally, custom-made devices allow for the treatment of arch or more extensive TAAAs. Endovascular treatment is applied not only to aneurysms but also to acute/chronic dissections. However, long-term outcomes are still unclear. This article provides an overview of available devices and the results of endovascular treatment for various aortic pathologies.

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Experience with the sandwich technique in endovascular thoracoabdominal aortic aneurysm repair

Abstract: The sandwich technique is an off-the-shelf endovascular alternative to treat patients with TAAAs in an emergent setting. The combination of chimney grafts with a periscope configuration enables a rapid endovascular aneurysm exclusion with acceptable midterm results.

Cited by 45 publications

References 21 publications

Standard “off-the-shelf” multibranched thoracoabdominal endograft in urgent and elective patients with single and staged procedures in a multicenter experience

Standard “off-the-shelf” multibranched thoracoabdominal endograft in urgent and elective patients with single and staged procedures in a multicenter experience

A case report of a hybrid procedure (visceral and partial aortic arch debranching) in the treatment of a challenging aneurysm of the thoracoabdominal aorta in the endovascular era

Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies

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