Presentation is loading. Please wait.

Presentation is loading. Please wait.

Directional tip control technique for optimal stent graft alignment in angulated proximal aortic landing zones  Toshio Takayama, MD, PhD, Patrick J. Phelan,

Published byGloria Ashlee Johnson Modified over 6 years ago

Similar presentations

Presentation on theme: "Directional tip control technique for optimal stent graft alignment in angulated proximal aortic landing zones  Toshio Takayama, MD, PhD, Patrick J. Phelan,"— Presentation transcript:

1 Directional tip control technique for optimal stent graft alignment in angulated proximal aortic landing zones  Toshio Takayama, MD, PhD, Patrick J. Phelan, MD, Jon S. Matsumura, MD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 3, Issue 2, Pages (June 2017) DOI: /j.jvscit Copyright © 2017 The Authors Terms and Conditions

2 Fig 1 Overview of the directional tip control technique. A, Infrarenal abdominal aortic aneurysm with angulated neck. B, Stent graft device does not fit the angulation by standard approach. C, Exchange the stiff wire to a floppy wire and snare it to create a through-and-through wire between bilateral groin access sites. D, Insert a steerable guiding sheath or angulated guiding catheter over the through-and-through wire from contralateral access site. Engage the tip of the guiding sheath or catheter to the device tip. E, Adjust the position of the device by manipulating the engaged guiding sheath or catheter so that the device fits the angulation of the aorta. F, Precisely deployed stent graft. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 51-56DOI: ( /j.jvscit ) Copyright © 2017 The Authors Terms and Conditions

3 Fig 2 An endovascular aneurysm repair (EVAR) case with the directional tip control technique. A, Preoperative computed tomography (CT) angiogram demonstrates infrarenal neck angle of 35 degrees. B, There was mural thrombus in the aneurysm neck (arrow). C, A 6.5F steerable guiding sheath engages to the stent graft device tip over the through-and-through wire (arrow). D, Deflected stent graft device position by manipulating the engaged steerable guiding sheath (arrowhead). E, Postoperative CT angiogram demonstrates an EVAR stent graft deployed orthogonal to the aortic centerline, just below the left renal artery. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 51-56DOI: ( /j.jvscit ) Copyright © 2017 The Authors Terms and Conditions

4 Fig 3 A thoracic endovascular aortic repair (TEVAR) case with the directional tip control technique. A, Preoperative computed tomography (CT) angiogram demonstrates that the angle between the centerlines of aortic arch zone 2 and proximal descending aorta was 70 degrees. B, A 5F angled catheter engages to the stent graft device tip over the through-and-through wire (arrow). Note that the through-and-through wire was between groin access and left brachial artery access. C, Deflected stent graft device position by manipulating the engaged catheter (arrowhead). D, Stent graft deployed parallel to the aortic arch without bird-beak configuration. E, Postoperative CT angiogram demonstrates well-aligned stent grafts and patent left subclavian artery snorkel stent. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 51-56DOI: ( /j.jvscit ) Copyright © 2017 The Authors Terms and Conditions

Download ppt "Directional tip control technique for optimal stent graft alignment in angulated proximal aortic landing zones  Toshio Takayama, MD, PhD, Patrick J. Phelan,"

Similar presentations

The impact of bird-beak configuration on aortic remodeling of distal arch pathology after thoracic endovascular aortic repair with the Zenith Pro-Form.

The impact of bird-beak configuration on aortic remodeling of distal arch pathology after thoracic endovascular aortic repair with the Zenith Pro-Form.
Aortic arch aneurysm repair using the Najuta stent graft in a challenging compromised seal zone  Naoki Toya, MD, Kota Shukuzawa, MD, Soichiro Fukushima,

Aortic arch aneurysm repair using the Najuta stent graft in a challenging compromised seal zone  Naoki Toya, MD, Kota Shukuzawa, MD, Soichiro Fukushima,
Raghuveer Vallabhaneni, MD, Jeffrey Jim, MD, Colin P

Raghuveer Vallabhaneni, MD, Jeffrey Jim, MD, Colin P
Combined Transcatheter Aortic Valve Replacement and Thoracic Endovascular Aortic Repair Using Transapical Access  Keith B. Allen, MD, Lesley M. Johnson,

Combined Transcatheter Aortic Valve Replacement and Thoracic Endovascular Aortic Repair Using Transapical Access  Keith B. Allen, MD, Lesley M. Johnson,
Stent-graft repair of traumatic thoracic aortic disruptions

Stent-graft repair of traumatic thoracic aortic disruptions
Fenestrated endovascular repair of aortic arch aneurysm in patients with bovine arch using the Najuta stent graft  Naoki Toya, MD, PhD, Takao Ohki, MD,

Fenestrated endovascular repair of aortic arch aneurysm in patients with bovine arch using the Najuta stent graft  Naoki Toya, MD, PhD, Takao Ohki, MD,
Acute bilateral renal artery chimney stent thrombosis after endovascular repair of a juxtarenal abdominal aortic aneurysm  Salvatore T. Scali, MD, Robert.

Acute bilateral renal artery chimney stent thrombosis after endovascular repair of a juxtarenal abdominal aortic aneurysm  Salvatore T. Scali, MD, Robert.
Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm  Ludovic.

Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm  Ludovic.
Embolization as cause of bowel ischemia after endovascular abdominal aortic aneurysm repair  Wayne W. Zhang, MD, Mahmoud N. Kulaylat, MD, Paul M. Anain,

Embolization as cause of bowel ischemia after endovascular abdominal aortic aneurysm repair  Wayne W. Zhang, MD, Mahmoud N. Kulaylat, MD, Paul M. Anain,
Initial clinical experience with a new low-profile thoracic endograft

Initial clinical experience with a new low-profile thoracic endograft
Novel technique for endovascular salvage of a folded aortic endograft

Novel technique for endovascular salvage of a folded aortic endograft
Salvage of bilateral renal artery occlusion after endovascular aneurysm repair with open splenorenal bypass  Samuel Jessula, MDCM, Christine R. Herman,

Salvage of bilateral renal artery occlusion after endovascular aneurysm repair with open splenorenal bypass  Samuel Jessula, MDCM, Christine R. Herman,
Covered endovascular repair of the paravisceral aorta

Covered endovascular repair of the paravisceral aorta
Covered endovascular repair of the paravisceral aorta

Covered endovascular repair of the paravisceral aorta
Thoracic Endovascular Aortic Repair Including Total Debranching on Femoral Artery for Arch Rupture  Yu Inaba, MD, Tsutomu Ito, MD, PhD, Sachiko Hayashi,

Thoracic Endovascular Aortic Repair Including Total Debranching on Femoral Artery for Arch Rupture  Yu Inaba, MD, Tsutomu Ito, MD, PhD, Sachiko Hayashi,
Late Gore Excluder endoprosthesis fabric tear leading to abdominal aortic aneurysm rupture 5 years after initial implant  Anand Dayama, MD, Nikolaos Tsilimparis,

Late Gore Excluder endoprosthesis fabric tear leading to abdominal aortic aneurysm rupture 5 years after initial implant  Anand Dayama, MD, Nikolaos Tsilimparis,
Safety and effectiveness of the INCRAFT AAA Stent Graft for endovascular repair of abdominal aortic aneurysms  Giovanni Torsello, MD, Dierk Scheinert,

Safety and effectiveness of the INCRAFT AAA Stent Graft for endovascular repair of abdominal aortic aneurysms  Giovanni Torsello, MD, Dierk Scheinert,
Initial experience with the Ventana fenestrated system for endovascular repair of juxtarenal and pararenal aortic aneurysms  Andrew Holden, MD, Renato.

Initial experience with the Ventana fenestrated system for endovascular repair of juxtarenal and pararenal aortic aneurysms  Andrew Holden, MD, Renato.
Emergency thoracic endovascular aortic repair with celiac artery coverage in hereditary hemorrhagic telangiectasia  Yuji Kawano, MD, Yuji Kanaoka, MD,

Emergency thoracic endovascular aortic repair with celiac artery coverage in hereditary hemorrhagic telangiectasia  Yuji Kawano, MD, Yuji Kanaoka, MD,
Endovascular stent graft for symptomatic mobile thrombus of the thoracic aorta  Philipp Fueglistaler, MD, Thomas Wolff, MD, Lorenz Guerke, MD, Peter Stierli,

Endovascular stent graft for symptomatic mobile thrombus of the thoracic aorta  Philipp Fueglistaler, MD, Thomas Wolff, MD, Lorenz Guerke, MD, Peter Stierli,

Similar presentations

Ads by Google