Endovascular repair of thoracic aortic lesions with the Zenith TX1 and TX2 thoracic grafts: Intermediate-term results Roy K. Greenberg, MD, Sean O’Neill,

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Endovascular repair of thoracic aortic lesions with the Zenith TX1 and TX2 thoracic grafts: Intermediate-term results Roy K. Greenberg, MD, Sean O’Neill, MD, Esteban Walker, PhD, Fady Haddad, MD, Sean P. Lyden, MD, Lars G. Svensson, MD, Bruce Lytle, MD, Daniel G. Clair, MD, Kenneth Ouriel, MD Journal of Vascular Surgery Volume 41, Issue 4, Pages 589-596 (April 2005) DOI: 10.1016/j.jvs.2005.01.043 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 The implant components of Zenith TX1 and TX2 systems. A, The TX1 has the proximal and distal fixation systems on a single component. B, The TX2 fixation system is split between a proximal (TX2P) and distal (TX2D) component, with an intended minimum of a two-stent overlap between them. Note the presence of caudally oriented barbs on the TX1 device and the proximal component of the TX2 system (red arrows). The proximal component of the TX2 system has no distal barbs and terminates distally in an internally mounted sealing stent. The distal TX2 component has a two-stent overlap zone where the stents are sutured to the internal portion of the polyethylene terephthalate material (yellow arrow). Distally, this piece has an uncovered stent with cranially oriented barbs (white arrow) in an effort to prevent proximal migration of the distal sealing stent. Fundamentally, the TX1 device was used to treat focal aortic pathology, whereas more diffuse disease was treated with a TX2 device. Journal of Vascular Surgery 2005 41, 589-596DOI: (10.1016/j.jvs.2005.01.043) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 The delivery system consists of (A) a tapered tip with a gradiant stiffness that may be precurved to fit into the aortic arch, a polytetrafluoroethylene sheath, and a handle. Three nitinol wires attach the proximal component to the delivery system. A single wire, in conjunction with the bottom cap (which constrains the distal uncovered stents with crainially oriented barbs), attaches the distal portion of the device (B and C, respectively). The delivery system for the proximal piece of the TX2 has only one trigger wire. D, After exposure of the prosthesis by sheath withdrawal, the single trigger wire is released (red arrow) allowing expansion of the proximal stent and barbs. E, The TX1 delivery system and distal component of the TX2 delivery system contain trigger wires for both the proximal and distal barbed regions (red arrows). Journal of Vascular Surgery 2005 41, 589-596DOI: (10.1016/j.jvs.2005.01.043) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Kaplan-Meier analysis of mortality. Results are expressed in terms of all cause mortality and thoracic aneurysm repair related mortality. TAA, thoracic aortic aneurysm. Journal of Vascular Surgery 2005 41, 589-596DOI: (10.1016/j.jvs.2005.01.043) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 Type of endoleak and temporal incidence of endoleak for the combined experience (all pathologies, all device types). Journal of Vascular Surgery 2005 41, 589-596DOI: (10.1016/j.jvs.2005.01.043) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions