Surgeon-modified fenestrated stent graft deployment in type B aortic dissection

İşcan, Hakkı Zafer; Ünal, Ertekin Utku

doi:10.5606/tgkdc.dergisi.2021.20641

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Our first case was for Zone 2 left subclavian artery (LSA) endo-revascularization with back table fenestration nearly two years ago for subacute type B aortic dissection and was the first documented SMFSG for LSA in Türkiye. [7] For a successful procedure, the surgeon must be accustomed to the endograft used. Every brand may be used for this purpose; however, we preferred the Ankura™ TAA Stent Graft owing to its conformity.…”

Section: (A) (B) (C)mentioning

confidence: 99%

Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus

İşcan

Tümer

Mavioğlu

2023

Turk Gogus Kalp Dama

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Currently, thoracic endovascular aortic repair is usually the first-line treatment option for descending aortic pathologies. Supra-aortic or visceral branches sometimes involve assistive thoracic endovascular aortic repair techniques; hybrid procedures or intentional coverage may be performed during the procedure to achieve a sufficient proximal or distal landing zone. Most surgeons may agree on selective coverage of celiac truncus, but revascularization is preferred to reduce the risk of ischemic complications. Herein, we present the first successful surgeonmodified fenestrated stent graft procedure for celiac truncus in a patient with Crawford type V descending aortic aneurysm in Türkiye.

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Section: (A) (B) (C)mentioning

confidence: 99%

Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus

İşcan

Tümer

Mavioğlu

2023

Turk Gogus Kalp Dama

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Surgeon-Modified Fenestrated Stent-grafts for Zone 2 Endovascular Repair of Blunt Traumatic Thoracic Aortic Injury: Early and Midterm Results

Mavioglu,

Iscan,

Askin

et al. 2023

J Endovasc Ther

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Aim: Blunt traumatic thoracic aortic injury (BTAI) is a highly fatal surgical emergency and is treated with endovascular procedures. We aimed to analyze and report the early and midterm outcomes of surgeon-modified fenestrated stent-grafts (SMFSG) compared with other conventional endovascular methods in patients with BTAI repaired with zone 2 endovascular surgery. Materials and Methods: Before and after the study was performed, from January 2015 to January 2020 for a period in which conventional endovascular treatments were used and from January 2020 to January 2023 for the second period in which the SMFSG technique was used. A total of 25 patients who underwent zone 2 endovascular repair for BTAI were included. The patients treated with conventional endovascular methods in the first period, chimney thoracic endovascular aortic repair (TEVAR) (n=3 patients); Left subclavian artery (LSA)-covered (intentionally total) (n=12 patients) LSA-covered (LSAC) TEVAR; carotid-subclavian bypass TEVAR (n=2 patients) was defined as group 1, and the group of patients treated with SMFSG in the second period was defined as group 2. The primary endpoints of the study were technical success, defined as complete closure of BTAI, and in-hospital mortality. Secondary outcomes were aortic pathology-related morbidity, mortality, and re-interventions during the follow-up period. Results: The mean age was 42.6±14.3 years, and 21 (84%) of the patients were male. The patients were compared with respect to the proximal landing zone, fluoroscopy time, duration of the procedure, length of intensive care unit stay, and hospital stay, no statistically significant difference was found between the 2 groups (p>0.05). The mean follow-up time of patients in group I was 46±9 months, while in group II, it was 14±6 months (p<0.001). While no TEVAR-related complications were detected in group II throughout follow-up, they occurred in 4 patients (28.6%) in group I. Conclusion: TEVAR is the most appropriate treatment for BTAI in the modern era, especially for polytrauma patients with successful outcomes. Intentional coverage of the LSA can be performed, but SMFSG is an effective, economical, rapid, and available technique for endovascular revascularization of the LSA. Clinical Impact Altough intentional left subclavian artery coverage is preferred routinely in patients with blunt traumatic aortic injury (in Zone 2) which is a highly fatal surgical emergency, surgeon-modified fenestrated stent-grafts is also effective, economical, rapid and available technique.

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Short-term results of chimney stent revascularization of left subclavian artery and Zone 2 thoracic endovascular aortic repair for patients with aortic dissection or transection

Altınay¹,

İnce²,

Bayyurt³

et al. 2022

Turk Gogus Kalp Dama

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Background: In this study, we present the short-term results of revascularization of left subclavian artery with the chimney technique in patients with aortic dissection or transection who underwent Zone 2 thoracic endovascular aortic repair. Methods: A total of 11 patients (6 males, 5 females; mean age: 56.4±11.5 years; range, 38 to 76 years) who underwent Zone 2 thoracic endovascular aortic repair procedure and left subclavian artery revascularization with the chimney technique between April 2017 and January 2020 in our clinic were retrospectively analyzed. All patients were followed at one, three, six months and one year with computed tomography angiography. Results: The mean follow-up was 19.7±14.5 (range, 6.3 to 45.8) months. Endoleak occurred in one (9%) patient and gutter leak occurred in three (27%) patients. The mean endoleak-free (including gutter leak) time was 19.9±5.4 (95% confidence interval: 9.36-30.34) months. No mortality occurred in any of the patients. No occlusion occurred in the chimney grafts. Conclusion: The chimney revascularization technique is an alternative to other revascularization techniques of the left subclavian artery during thoracic endovascular aortic repair.

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Surgeon-modified fenestrated stent graft deployment in type B aortic dissection

Cited by 3 publications

References 6 publications

Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus

Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus

Surgeon-Modified Fenestrated Stent-grafts for Zone 2 Endovascular Repair of Blunt Traumatic Thoracic Aortic Injury: Early and Midterm Results

Short-term results of chimney stent revascularization of left subclavian artery and Zone 2 thoracic endovascular aortic repair for patients with aortic dissection or transection

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