Document Detail


Fenestrated and branched stent grafts.
MedLine Citation:
PMID:  18644809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is estimated that 50% of patients with abdominal aortic aneurysms are not candidates for endovascular repair using the currently commercially available devices because of unfavorable anatomy. This includes patients with short or angulated necks, aneurysmal extension into either internal iliac artery, or complex aneurysmal involvement of the juxtarenal, paravisceral, and thoracoabdominal aorta. Good surgical candidates may tolerate open conventional repair of the aneurysm, but patients with large aneurysms and poor cardiac, pulmonary, or renal performance have limited options. Fenestrated and branched stent grafts were designed to extend the proximal sealing zone from the infrarenal segment to the juxta and suprarenal aorta, thereby circumventing the limitation of short or absent aortic necks. Since the first implantation of a fenestrated graft in 1996, there has been tremendous advancement in the development and technology of these devices. It is now possible to treat pathology of the entire aorta via a completely endovascular approach, with short-term results that compare favorably with those of open surgery. This review presents the current world experience with fenestrated and branched stent grafting. It encompasses the historical background of these devices, describes the techniques of fenestrated and branched grafting, summarizes the intermediate-term results for endovascular repair of pararenal, juxtarenal, thoracoabdominal, and aortoiliac aneurysms, and discusses the role of surgeon-modified fenestrated and branched devices.
Authors:
Joseph J Ricotta; Gustavo S Oderich
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Perspectives in vascular surgery and endovascular therapy     Volume:  20     ISSN:  1531-0035     ISO Abbreviation:  Perspect Vasc Surg Endovasc Ther     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-10-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100970607     Medline TA:  Perspect Vasc Surg Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  174-87; discussion 188-9     Citation Subset:  IM    
Affiliation:
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. ricotta.joseph@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm, Abdominal / radiography,  surgery*
Aortic Aneurysm, Thoracic / pathology,  surgery*
Aortography
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Humans
Patient Selection
Prosthesis Design
Risk Assessment
Stents*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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