Severe infolding of fenestrated-branched endovascular stent graft

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Presentation transcript:

Severe infolding of fenestrated-branched endovascular stent graft Aleem K. Mirza, MD, Giuliano A. Sandri, MD, Emanuel R. Tenorio, MD, PhD, Jussi M. Kärkkäinen, MD, PhD, Gustavo S. Oderich, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 4, Issue 3, Pages 240-243 (September 2018) DOI: 10.1016/j.jvscit.2018.05.001 Copyright © 2018 The Authors Terms and Conditions

Fig 1 Infolding of fenestrated stent graft due to excessive oversizing caused a type I endoleak. SMA, Superior mesenteric artery. Reproduced by permission of Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 240-243DOI: (10.1016/j.jvscit.2018.05.001) Copyright © 2018 The Authors Terms and Conditions

Fig 2 Infolded aortic stent across the fenestrated segment (A) requires protection of each of the side stents by sheath and balloon (B). Placement of a Palmaz stent in the proximal sealing stent (C) followed by dilation of the visceral segment of the graft (D), balloon dilation of each side stent (E), and the aorta (F) allows complete expansion of the aortic graft (G). Reproduced by permission of Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 240-243DOI: (10.1016/j.jvscit.2018.05.001) Copyright © 2018 The Authors Terms and Conditions

Fig 3 Fenestrations have been based on wider graft diameters to promote apposition between the graft fabric and the aortic wall. Some designs may start the tapered segment in the superior mesenteric artery (SMA), ending below the renal arteries (A), or use the traditional design of rapid tapering below the renals (B). The design illustrated in (A) could have avoided the infolded aortic stent in this case. Reproduced by permission of Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 240-243DOI: (10.1016/j.jvscit.2018.05.001) Copyright © 2018 The Authors Terms and Conditions