Performance of Bridging Stent Grafts in Fenestrated and Branched Aortic Endografting

Abstract

The currently used BSGs had low occlusion and re-intervention rates. Modifications of the branched design or dedicated BSG devices may improve outcome, especially after bEVAR.

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

“…Secondary patency was also high; no cases of restenosis or reocclusions were reported in this series. In the literature, most TVV occlusions are encountered within 12 to 24 months, 23,30,31 and therefore the low incidence in this series may be associated with the relatively short follow-up and the mortality rate in the urgent/emergent group. As reported in the literature, 32,33 most common TVV loss is experienced in the renal vessels, which may be due to acute renal angulation, greater motion during respiration, and higher end-organ perfusion resistance.…”

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

“…Important factors contributing to technical failure include the inadequate device design and suboptimal procedure planning. 86 Intraoperative technical failure was reported only 1.1% and 2.1% by Verhoeven et al 22 and by Mastracci et al, 31 suggesting that expertise is of paramount importance.…”

“…33 The renal artery as a target vessel was strongly correlated with perioperative vessel related events (technical failure, vessel injuries and early occlusions). 86 Renal insults not requiring hemodialysis, such as iatrogenic arteriovenous fistula, perinephric hemorrhages and small infarcts to the renal pole, are not uncommon. 21,82,98 Postoperative evolution of estimated glomerular filtration rate (eGFR) has been reported in a few studies.…”

“…42 As increasingly complex aortic pathology is treated via endovascular means, innovation has been driven through the use of novel techniques and devices customized in consultation with manufacturers. 75 For example, the combination of fenestrations and branches in the same proximal SG component has been used in narrow or angulated reno-visceral aortic segments, 86 or internal/external cuffs (axially oriented or caudally directed) for TAAAs and PRAs. 87 Moreover, to overcome the necessity of aortic main body customization, off-the-shelf devices have become apparent.…”

Adapting to a total endovascular approach for complex aortic aneurysm repair: Outcomes after fenestrated and branched endovascular aortic repair

“…Outcomes for branch vessel patency and instability, for example, are of particular concern but are also difficult to interpret because of the heterogeneity of technique and graft construction. 8,9 Some authors have called for a unique nomenclature for target vessel follow-up. [10][11][12] Comparisons against open surgical repair are also difficult.…”