Preliminary Results from a Prospective Study of Laparoscopic Aortobifemoral Bypass Using a Clampless and Sutureless Aortic Anastomotic Technique

Segers, Bernard; Horn, D. B.; Lemaı̂tre, Jean; Roman, Alain; Stevens, Etienne; Broeck, V. Van Den; Hizette, P.; Bosschaerts, Thierry

doi:10.1016/j.ejvs.2014.06.036

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…The technique was faster than the conventional suture technique and after 30 days had a similar tensile strength. This may open the use of this technique in complex debranching procedures, totally telescoped grafts and even facilitating the laparoscopic aortic anastomosis [ 10 ] . New hybrid devices may be developed for these applications.…”

Section: Resultsmentioning

confidence: 99%

Experimental Model for Sutureless Proximal Anastomosis by the ViaBahn Open Revascularization Technique (VORTEC)

Freire¹,

Gobbi²,

Fabbro³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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IntroductionIn the treatment of complex aneurysms, debranching is an extra-anatomical revascularization of visceral arteries followed by endograft coverage of the thoracoabdominal aorta. It eliminates the need for a thoracotomy and aortic clamping, but requires the performance of several technically demanding visceral anastomosis. In 2008, Lachat described visceral revascularization with the use of a sutureless distal anastomosis, performed by the telescoping of an endograft in the visceral branch, named VORTEC (Viabahn Open Revascularization TEChnique).ObjectiveAn experimental model was created to test the feasibility and short term results of performing a telescoped proximal anastomosis to the abdominal aorta.MethodsSwine model. The abdominal aorta was dissected and ligated between the renal arteries and the iliac vessels. Three centimeters bellow the renal arteries a Viabahn endograft was telescoped for 2 cm into the proximal aorta. The other extremity was conventionally anastomosed to the distal aorta. Patency, sealing and tensile strength of the anastomosis were tested.ResultsTime for performing the telescoped anastomosis was shorter (5.4±2.8 min versus 10.3±3.4 min, P<0.05). All grafts were patent and both types of anastomosis presented no bleeding. Immediate tensile strength showed a higher strength of the conventional suture (22.7 x 14.3 N, P<0.09). After 30 days there was no pseudo-aneurysms and the strength of the conventional and VORTEC anastomosis were similar (37.3 x 40.8 N, respectively, P=0.17).ConclusionTelescoped proximal anastomosis by the technique of VORTEC is feasible. After 30 days the tensile strength of the both anastomosis were similar.

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Section: Resultsmentioning

confidence: 99%

Experimental Model for Sutureless Proximal Anastomosis by the ViaBahn Open Revascularization Technique (VORTEC)

Freire¹,

Gobbi²,

Fabbro³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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“…In 2008, Lachat et al 12 introduced the Viabahn Open Revascularization TEChnique (VORTEC), in which a stent graft is used to form a sutureless anastomosis in renal revascularization surgery. Since then, several authors (Bonvini et al, 13 Segers et al, 14,15 Donas et al, 16 Papadimitriou et al 17 ) have attempted to use this technique in aortic surgery. According to this technique, the aorta is punctured and a guidewire is positioned in the aorta.…”

Section: Aad Typesmentioning

confidence: 99%

“…devices during open surgery, whereas five studies [13][14][15][16][17] reported a laparoscopic approach. Only two studies 34,45 reported comparative results of postoperative outcomes for hand-sewn anastomosis vs AADs.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%

Α systematic review and meta-analysis of the efficacy of aortic anastomotic devices

Manolesou

Papaioannou

Georgiopoulos

et al. 2019

Journal of Vascular Surgery

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Objective: One of the factors contributing to complications related to open repair of the aorta is the construction of a hand-sewn anastomosis. Aortic anastomotic devices (AADs), such as the intraluminal ringed graft (IRG), and the anastomotic stenting technique have been developed to perform a sutureless and less complicated anastomosis. This study performed a systematic review and meta-analysis of the literature reporting clinical use of AADs and aimed to assess, primarily, the effect of each device on 30-day overall and operation-related mortality and aortic cross-clamping time and, secondarily, the rate of successful two-sided application of the IRG device and the operation-related morbidity for each device.Methods: An electronic search was performed using MEDLINE, Scopus, ScienceDirect, and Cochrane Library by two independent authors. Our exclusion criteria included studies incorporating fewer than three patients and studies reporting results solely from animals or in vitro testing, results solely from end-to-side anastomosis, and results solely from endarterectomy procedures. The last search date was February 1, 2018.Results: A total of 41 studies were identified that reported outcomes for the use of three different device types: IRG, anastomotic stenting technique, and surgical staplers. The last two types were classified together as the non-IRG group. The meta-analysis included 27 studies with 50 cohorts incorporating 1260 patients. The median age of the incorporated patients was 61.4 years (range, 51-73 years), and 68.9% were male. The operations were performed for the treatment of acute aortic dissection in 82.3%. The pooled overall 30-day mortality rate varied by device type; IRG devices had a mean rate of all-cause mortality of 9.71%, whereas non-IRG devices were associated with a significantly (I 2 ¼ 15.78%; P for Cochrane Q test < .19) lower rate of death (1.47%). The pooled mean aortic cross-clamping time was 35.83 minutes. Metaregression showed that the performance of two-sided anastomosis with the IRG device significantly decreased the aortic cross-clamping time. However, a successful two-sided ringed anastomosis was performed in approximately half of the cases.Conclusions: Taking into account that the majority of operations were performed for the treatment of acute aortic dissection, AADs had a relatively low rate of 30-day mortality. Despite the observed heterogeneity in study protocols and the small sample size in the non-IRG group, the non-IRG group presented with the lowest 30-day mortality rate. Specific device-related complications between the different device types need further investigation.

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“…3 Papadimitriou et al 4 reported the use of a sutureless anastomosis in 6 patients with calcified aortas, using a stent-graft telescoped into the infrarenal aorta and partly deployed within and partly outside the aorta as a bridge between the target artery and the Dacron graft. Recently, Segers et al 5 described a similar sutureless anastomosis technique in a calcified infrarenal aorta using a laparoscopic approach. Compared with the approach we used, these techniques have the advantage of avoiding surgical suture; however, in order to obtain good seal of the endograft, at least 2 cm of overlap are required into the native aorta and 2 cm into the Dacron graft.…”

Section: Journal Of Endovascular Therapy 22(2)mentioning

confidence: 99%

Aortic Hybrid Sutureless Anastomosis on Porcelain Aorta

et al. 2015

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Preliminary Results from a Prospective Study of Laparoscopic Aortobifemoral Bypass Using a Clampless and Sutureless Aortic Anastomotic Technique

Cited by 7 publications

References 20 publications

Experimental Model for Sutureless Proximal Anastomosis by the ViaBahn Open Revascularization Technique (VORTEC)

Experimental Model for Sutureless Proximal Anastomosis by the ViaBahn Open Revascularization Technique (VORTEC)

Α systematic review and meta-analysis of the efficacy of aortic anastomotic devices

Aortic Hybrid Sutureless Anastomosis on Porcelain Aorta

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