Multibranched endovascular repair using a modified endograft with hydrogel-reinforced fenestrations

Azuma, Takashi; Yokoi, Y; Hayakawa, Namiko; Domoto, Satoru; Niinami, Hiroshi

doi:10.1093/ejcts/ezac042

Cited by 4 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another interesting and clinically useful innovation may be hydrogel-enhanced refenestration, as recently reported by Azuma et al [19]. The reinforcement of restenestrations may thus allow the treatment of not only juxtarenal but also complex thoracoabdominal aneurysms in the future.…”

Section: Discussionmentioning

confidence: 94%

Comparison of the Snare Loop Technique and the Hungaroring Reinforcement for Physician-Modified Endograft Fenestrations—An In Vitro Study

Hüttl,

Nguyen,

Borzsák

et al. 2024

JCDD

View full text Add to dashboard Cite

Background: We conducted an in vitro comparison of the snare loop reinforcement against a closed-loop reinforcement (Hungaroring) for physician-modified endograft (PMEG) fenestrations regarding preparation time and stability during flaring balloon dilatation. Materials and methods: The time to complete a PMEG fenestration with reinforcement was measured and compared between the Hungaroring and snare loop groups. The number of stitches was counted. Each fenestration was dilated using a 10 mm high-pressure, non-compliant balloon up to 21 atm in pressure, and fluoroscopic images were taken. The presence of indentation on the oversized balloon at the level of the reinforcement was evaluated at each fenestration. Results: Five fenestrations were created in each group (n = 5) for a total of ten pieces. The completion time in the snare loop group was 1070 s (IQR:1010–1090) compared to 760 s (IQR:685–784) in the Hungaroring group (p = 0.008). Faster completion time was achieved by faster stitching (23.2 s/stitch (IQR 22.8–27.3) for the snare loop group and 17.3 s/stitch (IQR 17.3–20.1) for the Hungaroring group (p = 0.016). None of the fluoroscopic images of the snare loop reinforcement showed an indentation on the balloon during the overexpansion; on the contrary, the Hungaroring showed indentation in every case, even at 21 atm. Conclusion: Fenestrations reinforced with Hungaroring can be completed significantly faster. Furthermore, the Hungaroring resists over-dilation even at high pressures, while snare loop reinforcements dilate at nominal pressure.

show abstract

Section: Discussionmentioning

confidence: 94%

Comparison of the Snare Loop Technique and the Hungaroring Reinforcement for Physician-Modified Endograft Fenestrations—An In Vitro Study

Hüttl,

Nguyen,

Borzsák

et al. 2024

JCDD

View full text Add to dashboard Cite

show abstract

Remodelers of the vascular microenvironment: The effect of biopolymeric hydrogels on vascular diseases

Li,

Jin,

Yang

2024

International Journal of Biological Macromolecules

View full text Add to dashboard Cite

Mid-term outcomes of physician-modified endograft therapy for complex aortic aneurysms

Shibata,

Mitsuoka,

Iba

et al. 2024

Interdisciplinary CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

OBJECTIVES To evaluate early and mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms from 10 Japanese aortic centres. METHODS From January 2012 to March 2022, 121 consecutive adult patients who underwent physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were enrolled. We analysed early and mid-term postoperative outcomes, including postoperative complications and mortality. RESULTS The pararenal and thoraco-abdominal aortic aneurysms groups included 62 (51.2%) and 59 (48.8%) patients, respectively. The overall in-hospital mortality rate was 5.8% (n = 7), with mortality rates of 3.2% (n = 2) and 8.5% (n = 5) in pararenal and thoraco-abdominal aortic aneurysm groups, respectively (P = 0.225). Type IIIc endoleaks occurred postoperatively in 18 patients (14.9%), with a significantly higher incidence (P = 0.033) in the thoraco-abdominal aortic aneurysms group (22.0%, n = 13) than in the other group (8.1%, n = 5). Major adverse events occurred in 7 (11.3%) and 14 (23.7%) patients in pararenal and thoraco-abdominal aortic aneurysm groups (P = 0.074), respectively. The mean follow-up period was 24.2 months. At the 3-year mark, both groups significantly differed in freedom from all-cause mortality (83.3% and 54.1%, P = 0.004), target aneurysm-related mortality (96.8% and 82.7%, P = 0.013), and any reintervention (89.3% and 65.6%, P = 0.002). Univariate and multivariate regression analyses demonstrated that ruptures, thoraco-abdominal aortic aneurysms, and postoperative type IIIc endoleaks were associated with an increased risk of all-cause mortality. CONCLUSIONS The mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were clinically acceptable and comparable with those in other recently published studies. Notably, pararenal and thoraco-abdominal aortic aneurysms represent distinct pathological entities with different postoperative outcomes.

show abstract

Multibranched endovascular repair using a modified endograft with hydrogel-reinforced fenestrations

Cited by 4 publications

References 24 publications

Comparison of the Snare Loop Technique and the Hungaroring Reinforcement for Physician-Modified Endograft Fenestrations—An In Vitro Study

Comparison of the Snare Loop Technique and the Hungaroring Reinforcement for Physician-Modified Endograft Fenestrations—An In Vitro Study

Remodelers of the vascular microenvironment: The effect of biopolymeric hydrogels on vascular diseases

Mid-term outcomes of physician-modified endograft therapy for complex aortic aneurysms

Contact Info

Product

Resources

About