Initial clinical experience with a new low-profile thoracic endograft

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Presentation transcript:

Initial clinical experience with a new low-profile thoracic endograft Germano Melissano, MD, Yamume Tshomba, MD, Enrico Rinaldi, MD, Roberto Chiesa, MD Journal of Vascular Surgery Volume 62, Issue 2, Pages 336-342 (August 2015) DOI: 10.1016/j.jvs.2015.02.049 Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 1 During stent graft deployment, the proximal and distal stents are constrained by metal wires that also affix the endograft to the central cannula of the delivery system, which is precurved. Courtesy of Blayne Roeder, PhD, Director of Product Development-Aortic Intervention, Cook Medical. Journal of Vascular Surgery 2015 62, 336-342DOI: (10.1016/j.jvs.2015.02.049) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 2 Intraoperative angiography showing occlusion of the right iliofemoral axis with a significant stenosis at the origin of the left common iliac artery requiring a balloon angioplasty before thoracic endograft insertion. Journal of Vascular Surgery 2015 62, 336-342DOI: (10.1016/j.jvs.2015.02.049) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 3 Preoperative (A) and postoperative (B) computed tomography (CT) angiography showing a degenerative aneurysm in the middle third of the descending thoracic aorta before and after successful exclusion with two largely overlapped Cook Zenith Alpha thoracic stent grafts in a patient with severe aortoiliac occlusive disease. Thanks to the modular strategy, extremely precise proximal and distal stent graft landing is achievable with an in situ adjustment of the distal component. Of note (arrows), the critical intercostal artery directly feeding the anterior spinal artery is left intentionally uncovered after distal component deployment. Journal of Vascular Surgery 2015 62, 336-342DOI: (10.1016/j.jvs.2015.02.049) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 4 A, Preoperative computed tomography (CT) angiography showing a degenerative aneurysm with floating thrombus in the proximal third of the descending thoracic aorta in a patient with a bovine arch. B, Postoperative CT angiography showing successful aneurysm exclusion with a proximal component of Cook Zenith Alpha thoracic stent graft landed in zone 2 according to Ishimaru's classification. Note the good endograft conformance to the aortic arch anatomy without bird's beak sign. Journal of Vascular Surgery 2015 62, 336-342DOI: (10.1016/j.jvs.2015.02.049) Copyright © 2015 Society for Vascular Surgery Terms and Conditions