| Diameter-reducing wire to facilitate deployment of a modified Zenith fenestrated stent graft. | |
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MedLine Citation:
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PMID: 20832004 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Modified fenestrated stent grafts have been used for compassionate treatment of large complex aortic aneurysms in high-risk patients who do not have access to a manufactured device and are not candidates for conventional open surgical repair. Accurate device design and precise implantation are key components of the procedure. A technique of device modification with diameter-reducing wire is described to facilitate catheterization of side branches. METHODS: The modified Cook Zenith stent graft was created using reinforced fenestrations with gold nitinol markers. The stainless steel wire, which secures the top cap into the uncovered stent, was partially withdrawn, retrieved, and redirected externally through-and-through the fabric of the stent graft. Each Z-stent was constrained using the stainless steel wire for support and by two nonlocking prolene loops. The constrained stent graft was 30% narrower than the unconstrained device, which allowed flow between the stent graft and the aortic wall, as well as longitudinal and rotational movement of the stent graft. After successful catheterization of the fenestrations, balloon-expandable stent grafts were advanced over hydrophilic sheaths, and the stainless steel diameter-reducing wire was removed with full expansion of the Z-stents to its unconstrained diameter. The fenestrations were stented with balloon-expandable stent grafts, followed by placement of iliac limbs CONCLUSION: The use of a diameter-reducing wire allows longitudinal and rotational movement to the modified fenestrated stent graft and facilitates side branch catherization in patients in whom there is misalignment between the fenestration and the origin of the target vessel. |
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Authors:
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Gustavo S Oderich |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Annals of vascular surgery Volume: 24 ISSN: 1615-5947 ISO Abbreviation: Ann Vasc Surg Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 980-4 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN 55905, USA. oderich.gustavo@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Aneurysm, Abdominal / radiography, surgery* Aortography / methods Blood Vessel Prosthesis* Blood Vessel Prosthesis Implantation / instrumentation*, methods* Female Humans Prosthesis Design Stents* Tomography, X-Ray Computed Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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