Disease of the Distal Thoracal Aorta, Treated by Endovascular Aorta-Stent-Graft, or Surgical Operation

-graft (Medtronic, Sunnyvale, CA) with self-expandable nitinol stent rings sutured to the graft made of thin graft (Medtronic; fully stented graft with self-expandable nitinol stent rings; graft made of thin-walled noncrimped, woven ...

This report describes the transluminal placement of a stent graft occlusion device to treat a celiac bypass graft pseudoaneurysm which was causing biliary and duodenal obstruction.

The author reports a case of a successful retrieval of a stent-graft in a young patient with a femoral dialysis graft. The stent-graft was used to treat a resistant occluded segment of the arterial limb of the graft. However, the stent-graft was inadvertently deployed partially into the ...

Now stent-grafting is regarded as 1st-line treatment for thoracic aortic aneurysm in the setting of favorable anatomic situation. Therefore all the hospitals that have the department of cardiovascular surgery should be capable of performing stent-grafting. Japanese committee of stent-graft management set criteria for the equipment and ...

We present a case of endovascular stenting for aortic recoarctation complicated by acute aortic rupture, which was successfully treated by emergency stent graft deployment. This case illustrates the potential serious complication that can occur during aortic stent dilatation and how the prompt deployment of a ...

Endovascular procedures are frequently used as an alternative to surgical bypass in aortic and iliac occlusion. Stents have revolutionized the scope of such endovascular procedures, but there are few reports of stents or stent grafts in occlusive juxta-renal aortic occlusion. We present a case where such occlusion ...

Anatomically straightforward aneurysms of the descending aorta can be safely treated with the most stent-grafts. Patients with thoracic aneurysm have often thin, tortuous and calcified access vessels and require low profile and flexible delivery systems. The deployment of stent grafts in the aortic arch is challenging requiring perfect ...

We present a patient with a splenic arterypseudoaneurysm (SAPA) treated with placement of self-expandable stent-grafts. The procedure was complicated by stent-graft migration,but successful management resulted in lasting exclusion of the SAPA,while the patency of the splenic artery was preserved. This is the first report of self-expandable ...

This study evaluated the efficacy of utilizing the fibrin-adhesive-system in lieu of a mandibular stent in securing split thickness skin grafts during vestibuloplasty procedures. The technique proved to be easier and less time-consuming than stent utiliza...

is the AneuRx�� AAA Stent Graft System (Medtronic, Inc.; Sunnyvale, Calif), which has self-expandable Nitinol-graft, a fully stented graft with self-expandable Nitinol stent rings. Made of thin-walled, noncrimped, woven polyester sutured to the Nitinol ...

(PU) graft with nitinol stents can be used to design a patient specific SG for aortic aneurysm repair. In this project, nitinol Z-shaped stents were placed between two layers of PU. (Oversized) bare stents (BS) were aorta is more realistic. It can be concluded that a SG composed of a polyurethane ...

We report the use of a Dacron-covered Gianturco-Roesch Z (GRZ)-stent to treat malignant obstruction of the superior vena cava (SVC). Initial treatment with an uncovered GRZ-stent was suboptimal due to protrusion of tumor-thrombus through the stent struts into the SVC lumen. Placement of a coaxial Dacron-covered ...

The endovascular repair of abdominal aortic aneurysm (AAA) with stent grafts is rapidly becoming an important alternative to open repair. Suprarenal stent grafting, recently modified from conventional infrarenal stent grafting, is a technique for the purpose of treating ...

The endovascular repair of abdominal aorticaneurysm (AAA) with stent grafts is rapidly becoming an important alternative to open repair. Suprarenal stent grafting, recently modified from conventional infrarenal stent grafting, is a technique for the purpose of treating ...

In this paper a method is introduced, to visualize bifurcated stent grafts in CT-Data. The aim is to improve therapy planning for minimal invasive treatment of abdominal aortic aneurysms (AAA). Due to precise measurement of the abdominal aortic aneurysm and exact simulation of the bifurcated stent graft, physicians ...

Elective stent graft repair of iliac aneurysm is successful and safe. There are, however, few published data on stent grafting unstable patients with acute iliac aneurysm rupture. Iliac diameter mismatch can also present a challenge to emergency endovascular treatment. We report the treatment of an unstable patient ...

Strozzi and Ani?Stents in Patients with Acute Coronary SyndromeAimTo compare polytetrafluoroethylene stent graft (PTFE) with sirolimus and bare metal stents in reducing in-stent restenosis in native coronary vessels in patients with acute coronary syndrome.MethodsThe study included patients who ...

Endovascular aortic stent-graft is a new, minimally invasive procedure for treating thoracic aortic diseases, and has quickly evolved to be one of the standard treatments subject to anatomic constraints. This procedure involves the placement of a self-expanding stent-graft system in a high-flow thoracic aorta. Stent-graft deployment in ...

Fenestrated stent grafts have been developed to treat patients with abdominal aortic aneurysms (AAA) associated with complicated aneurysm necks, such as short necks, severe angulated or poor quality necks (presence of calcification or thrombus). The technique is performed by creating an opening in the graft material so that the ...

An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by ...

This case report describes repair of a type I endoleak at the distal landing zone of a thoracic aortic stent graft by endovascular placement of a thoracoabdominal fenestrated stent graft (Cook, Brisbane, Australia). The fenestrated stent graft was interposed between a ...

We report the case of a patient with subtotal occlusion of the origin of the left common carotid artery (CCA) following thoracic graft placement. Retrograde endovascular placement of a stent-graft by minimal cervical access was undertaken to repair the occlusive lesion of the left CCA and prevent future complications of endoluminal thoracic reconstruction. ...

Endovascular aortic replacement (EVAR) is an established technique, which uses stent grafts to treat aortic aneurysms in patients at risk of aneurysm rupture. Late stent graft failure is a serious complication in endovascular repair of aortic aneurysms. Better understanding of the motion characteristics of ...

We report on N-butyl 2-cyanoacrylate embolization and subsequent endovascular stent graft placement for the treatment of an aortoesophageal fistula secondary to placement of an esophageal stent. A 53-year-old man with lung cancer was admitted with massive hematemesis due to the formation of an aortoesophageal fistula 20 days after ...

Arteriovenous fistulas (AVFs) are infrequently seen in the civilian health-care system; traditionally, these lesions have been treated with ligation, or direct surgical repair with concomitant revascularization. We describe a rare case of a peroneal AVF treated with a stent-graft.

We report a successful repair of a ruptured tuberculous pseudoaneurysm of the descending thoracic aorta by endovascular stent graft placement. This procedure is starting to be accepted as an alternative method to surgery, and we review similar cases in the literature.

Acute aortic syndrome of the descending aorta can be treated with stent-graft thanks to technical and material development. Ruptured aneurysms, aortic dissection, wall hematoma and penetrating ulcers can be treated with stent-graft. According to the type of initial lesion, and the clinical tolerance, the emergency of treatment can be different. Non covered ...

Coronary perforation is an uncommon complication of angioplasty and is a challenging situation to manage. We describe a case of complex multivessel coronary angioplasty complicated by coronary perforation following balloon rupture that was successfully managed with a coronary stent graft. Delivery of the stent ...

Pseudoaneurysm is a relatively rare but serious complication of pancreatitis which is often fatal. We report successful stent-graft placement in the superior mesenteric artery in a 45-year-old man with a pancreatic pseudocyst that grew during therapy for chronic pancreatitis and developed into a pseudoaneurysm. After a stent graft was ...

The deployment of a Medtronic AneuRx stent-graft system for endovascular abdominal aortic aneurysm repair requires a series of precise maneuvers that include positioning the primary delivery catheter in the infrarenal aorta, retracting the graft-covering sheath, and withdrawing the stainless steel runners. The last step allows the ...

We present the case of a 62-year-old woman who presented with recoarctation and then experienced rupture of the aorta and severe clinical deterioration after a stent was deployed. She was treated immediately by intrastent deployment of a stent-graft, which resolved the extremely serious situation.

Heparins are glycosaminoglycans that, in addition to their anticoagulant activity, have interactions with growth factors and other glycoproteins. These interactions may stimulate neointimal hyperplasia when heparin is delivered locally on stents and stent-grafts. Modifying the structure of heparin to retain anticoagulant activity while minimizing these ...

To lower the risk of stent migration in a graft-venous anastomosis stenosis following failed percutaneous transluminal angioplasty, two Strecker stents of different caliber were placed in partly overlapping fashion across the stenosis. In contrast to other methods, stent 'floating' on the venous ...

Aneurysms of the visceral arteries are rare. Traditional treatment has been surgical or endovascular with coil embolization. Recently, however, reports on endovascular therapy with stent-grafts have been published. We report the case of a 61-year-old man who was successfully treated with a stent-graft for a symptomatic combined celiac/hepatic artery ...

Stent-graft exclusion of an ischemic, hilar portobiliary fistula after liver transplantation has not been reported. Isolated reports have described peripheral or nonischemic fistulas, and alternative treatment options have ranged from balloon tamponade to surgical repair. We present a unique case of a hilar portobiliary fistula successfully treated to resolution by unilateral ...

Rupture of an iliac artery during percutaneous transluminal coronary angioplasty is a rare but potentially devastating complication. We report a case of iatrogenic external iliac artery rupture that was successfully treated by temporary balloon occlusion followed by endovascular stent graft placement in an unusual manner. Limited availability of the ...

Following complicated aortic aneurysm surgery a complete left iliac occlusion resulted in buttock claudication. A retrogradely perfused right common iliac aneurysm expanded. Exclusion was by external-to-internal iliac stent-graft. No deterioration in claudication occurred with medium-term stent-graft patency.

Although the long-term durability of stent grafts is still a concern, stent-graft treatment is already the best option in a large number of patients with descending thoracic aortic diseases who are poor candidates for surgical repair, or in an acute setting. With improved capability to recognize proper anatomy and select clinical ...

Initial failure of successful deployment of endovascular aortic stent-grafts can be due to a variety of factors and frequently requires surgical intervention. We describe an endovascular technique for salvaging initially failed tubular aortic and bifurcated aortoiliac stent-grafts with reference to three cases.

We present the case of a 63-year-old woman with a short patent ductus arteriosus and aneurysmal pulmonary arteries who was treated by placement of a stent-graft. The technique proved simple and safe. Further research is required to improve the design of stent-grafts and their release system for use of this technique in adult patients with this disorder.

A three-dimensional model was constructed from helical CT images for abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA). A stent-graft was designed and positioned endoluminally on the computer. One hundred and nine stent-grafts for 101 patients were designed by this method and deployed well in all patients. The design time was reduced from ...

A 58-year-old man underwent an elective coronary bypass graft for severe four-vessel stenosis. Cardiogenic shock developed just after coronary bypass grafting with a LIMA to LAD and SVG to OM1/OM2 graft; the PDA was too small to graft. Despite significant inotropes and an IABP, the patient deteriorated in ICU with ...

Purpose. To retrospectively assess the feasibility, safety, and clinical mid-term outcome of patients undergoing carotid artery stenting with stent-grafts. Methods. Over a 4 year period stent-grafts were used in the endovascular treatment of symptomatic internal carotid artery stenosis in 12 patients (2 women, 10 men, aged 47-83 (mean ...

Endovascular stent grafting has emerged as an effective method for the treatment of complicated acute type B aortic dissections. In cases where access to the aorta cannot be established through the ileofemoral trunks, the axillary arteries are used as an alternative route. Often, however, these arteries are too small to accommodate the device sheath. We ...

Purpose. We evaluated the suitability of Dacron, polytetrafluoroethylene (PTFE), and small intestinal submucosa (SIS) as a covering material for stent-grafts placed in the portal vein as compared with a bare stent. Methods. Using 24 beagle dogs, either bare stents or stent-grafts covered with Dacron, PTFE, or SIS ...

Woman, 67 years old, with unstable angina and history of myocardial revascularization: left internal thoracic artery to anterior descending artery and graft with radial artery (RA) to right coronary artery branches. Coronariography showed stenosis of 90% in the RA graft, treated with conventional stent. After two months, the patient ...

Endovascular aortic stent-graft is a new, minimally invasive procedure for treating thoracic aortic diseases, and has quickly evolved to be one of the standard treatments subject to anatomic constraints. Stent-graft deployment in the thoracic aorta, especially close to the aortic arch, normally experiences a significant drag force which might lead to the ...

Three aging failing hemodialysis polytetrafluoroethylene bypass shunts, average age 44 months, previously percutaneously revised with balloon angioplasty, presented with pseudoaneurysms and recurrent thrombosis. All were treated with percutaneous covered stent placement within their affected limbs. One graft was ligated 1 month after treatment for infected ...

A bifurcated stent-graft signifies an improvement in surgical technique for treatment of a lesion in the branched blood vessel. However, there still remains a high failure rate regarding bifurcated stent-graft due to the occurrence of thrombosis or re-stenosis. The objectives of this study are to understand the effect of torsion in helical bifurcated ...

Aortic stent grafting may be an alternative to surgery for patients with an abdominal aortic aneurysm and coexistent horseshoe kidney but is not without difficulties. This study examines the renal consequences of aortic stent grafting in such patients. This is a retrospective review of patients with horseshoe ...

Endovascular exclusion of the abdominal aortic aneurysm (AAA) has been carried out in selected patients during the past decade. The deployment of a complex multicomponent endovascular device in an aneurysmal aorta may alter the local haemodynamics and lead to thrombosis and intimal hyperplasia development. The aim of this in vitro study was to investigate the flow patterns using flow visualisation ...

We report a case of internal mammary artery graft dissection. Cardiac catheterization showed a spiral dissection in the anastomotic site of internal mammary artery graft with TIMI 3 flow. Percutaneous stenting for native coronary artery lesions was performed. Cardiac catheterization, performed 2 years after the ...

One of the technical limitations of surgeon-modified fenestrated stent grafts is the lack of a diameter-reducing wire, which facilitates catheterization of target branches if there are errors of device design, alignment, or implantation. This article describes a technique of adding a diameter-reducing wire to the modified TX2 fenestrated ...

We present the case of a late superficial femoral artery stent disconnection causing an asymptomatic pseudoaneurysm successfully treated with a stent-graft. A 67-year-old female was referred to our department for evaluation of claudication of the left lower limb and was diagnosed to have a total occlusion of the superficial femoral artery. Three nitinol ...

Thoracic and abdominal aortic endovascular procedures as alternatives to aortic reoperations were studied in three different cases. An anastomotic aneurysm after previous thoracic aortic graft for coarctation, a second-stage elephant trunk repair (descending thoracic aortic aneurysm), and a secondary aneurysm proximal to a previous abdominal aortic graft ...

A 72-year old man who underwent aorto-bifemoral bypass with insertion of a Dacron graft 18 years previously presented with an aneurysm in the left limb of his graft. Angiography also demonstrated a bilateral occlusion of the popliteal arteries. Computed tomography (CT) angiography was performed and showed a localized dilation of 3 cm in the left limb of ...

Two cases of percutaneous endoluminal exclusion of a subclavian aneurysm with a Dacron-coated nitinol stent are presented. One subclavian aneurysm followed trauma; the other was due to thoracic outlet stenosis which was caused by a cervical rib. In both patients the aneurysm was excluded successfully. The follow-up periods were 22 and 14 months, respectively. Stenoses at the ...

An 81-year-old woman with ruptured mycotic thoracic aortic aneurysm was treated with endovascular placement of stent-grafts fabricated from expanded polytetrafluoroethylene and Z-stents. Although exclusion of the aneurysm was achieved at the end of the procedure, a type I endoleak developed on the following day.Despite emergent surgical resection of the ...

Aneurysmal lesions of the external carotid artery are extremely rare. A case is presented of a 3.8 cm right external carotid artery pseudoaneurysm treated by transluminal exclusion using an endovascular stent-graft. Following stent-graft placement, complete occlusion of the aneurysmal sac and main vessel lumen patency was successfully demonstrated. This ...

We present the case of a 77-year-old male patient who had undergone a bilateral venous aortorenal bypass graft 30 years previously. Thirteen years previously, the patient was shown to have a decrease in renal function, with mild shrinking of both kidneys; additionally, a stenosis was found in the left proximal anastomosis. At the most recent follow-up visit (1 year ...

Three patients with dialysis access graft shunts, having a symptomatic pseudoaneurysm and a hemodynamically significant stenosis at the anastomosis between the graft shunt and the subclavian vein, were treated with percutaneous transluminal angioplasty and insertion of a Wallstent. Pseudoaneurysms were excluded by percutaneous insertion of a Cragg Endo-Pro ...

Purpose: To describe the efficacy and value of endovascular stent-grafts for the treatment of aortic anastomotic pseudo-aneurysms.Methods: Three patients with proximal aortic anastomotic pseudoaneurysms 8-15 years after prosthetic reconstruction were treated by transfemoral stent-graft implantation. In two patients the pseudoaneurysms were excluded by ...

Purpose: To describe the efficacy and value of endovascular stent-grafts for the treatment of aortic anastomotic pseudoaneurysms.Methods: Three patients with proximal aortic anastomotic pseudoaneurysms 8-15 years after prosthetic reconstruction were treated by transfemoral stent-graft implantation. In two patients the pseudoaneurysms were excluded by ...

Our objective was to report the experience of endovascular therapy to treat patients with Takayasu arteritis (TA) and evaluate outcomes. A review was undertaken of TA patients treated with endovascular means during a 9-year (2004 to 2011) period. Patients were diagnosed using the American College of Rheumatology criteria and classified, based on angiographic criteria, using the Numano's ...

Aneurysms of saphenous vein grafts are rare but can result in complications such as myocardial infarction or death. Percutaneous treatment has included a variety of approaches, including covered stents. Long aneurysms in saphenous vein grafts pose an additional challenge due to the lack of coronary covered stents ...

Two patients with chronic type B aortic dissection underwent endovascular repair. The interval between the onset of aortic dissection and stent grafting was 1 year, 7 months in both patients. The entry closure was successful and postoperative course was uneventful for each patient. However, intimal injury developed at the bottom end of the ...

A patient who had previously undergone retrosternal gastric tube reconstruction for esophageal cancer presented with an aortic arch aneurysm. The patient was treated with endovascular stent-graft placement without median sternotomy, followed by revascularization of the brachiocephalic trunk using percutaneous in situ graft fenestration. A 9-month follow-up ...

Purpose: To evaluate the effect on dilatation of three types of covering materials used for endovascular stent-grafts.Methods: Stent-grafts with three types of covering material [0.1-mm polytetrafluoroethylene (PTFE), 0.2-mm PTFE, and 0.15-mm woven polyester] were placed in a fluid circuit. For the pulsatile pressure test, the luminal pressure of 190/130 ...

Endovascular stent graft repair of abdominal aortic aneurysm (AAA) has undergone rapid developments since it was introduced in the early 1990s. Two main types of aortic stent grafts have been developed and are currently being used in clinical practice to deal with patients with complicated or unsuitable aneurysm ...

Acute or subacute thrombosis and late restenosis remain the main limitations of permanent stenting. In an effort to address these limitations, an autologous vein graft-coated stent (AVGCS) was developed at our institution. This stent consists of a conventional stent (Palmaz or Palmaz-Schatz, ...

Four children, three boys and one girl, with a median age of 9 years 8 months, underwent transjugular intrahepatic portosystemic shunt creation with an expanded polytetrafluoroethylene (e-PTFE)-covered nitinol stent. The stent-graft was successfully placed in all four patients without any complication. Clinical and biochemical improvement was noted in all ...

We report the case of a patient who developed an asymptomatic pseudoaneurysm in the left external iliac artery after transplant nephrectomy. The pseudoaneurysm most probably arose as a suture aneurysm from the external iliac artery after removal of the graft renal artery. Obviously we can not exclude the possibility it was a true aneurysm, although this seems much less likely. ...

Fenestrated endovascular repair of an abdominal aortic aneurysm has been developed to treat patients with a short or complicated aneurysm neck. Fenestration involves creating an opening in the graft fabric to accommodate the orifice of the vessel that is targeted for preservation. Fixation of the fenestration to the renal arteries and the other visceral arteries can be done by ...

Structural failure and collapse of thoracic stent grafts may cause fatal complications that are easily overlooked on follow-up imaging. A young man with multiple injuries from a motorcycle crash was treated with endografting for an aortic transection. The clinical course was initially satisfactory but deteriorated one week after the injury and the patient ...

Percutaneous coronary intervention with stenting is widely used for ischemic heart disease. Because stent loss, which occurs rarely during the procedure, might have dire consequences, such as bleeding, stent embolism, acute myocardial infarction, emergency coronary artery bypass graft, and death, appropriate ...

The authors report two cases of stent-assisted embolization (SAE) in the aorta. In one case, SAE was performed for treatment of a pseudoaneurysm; the procedure consisted of stent placement and embolization with an AMPLATZER Vascular Plug and detachable coils through the stent struts. In the second case, SAE was performed to stop acute ...

Abstract Purpose: To quantify the compression force acting on target vessel stents as a consequence of the misalignment between the native aortic anatomy and the fenestrated stent-graft owing to measuring errors during the design of the device. Methods: The material properties of a fenestrated Zenith stent-graft were determined using a ...

Coronary artery stenosis is a major complication of Kawasaki disease (KD). Several interventional methods in treating coronary artery stenosis have been introduced. However, there are few reports on the management of in-stent restenosis after coronary stent implantation in children. Reported is a 10-year-old boy who underwent successful ...

Common iliac artery (CIA) aneurysms that extend into the iliac bifurcation and internal iliac artery (IIA) usually require exclusion of the IIA, exposing pelvic ischemic complication risks. This case report presents an endovascular technique of "cross-stenting" in a short proximal landing zone with complete exclusion of the CIA aneurysm using a covered ...

Purpose: To evaluate shunt patency after placing a new polyurethane-coated Dacron-covered spiral Z stent-graft to create a transjugular intrahepatic portosystemic shunt (TIPS). Methods: TIPS stent-grafts were placed in six young swine, using polyurethane-coated, Dacron-covered spiral Z stent-grafts. Animals were followed weekly by ...