| First United States experience of the TX2 Pro-Form thoracic delivery system. | |
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MedLine Citation:
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PMID: 20801606 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Failure to conform to the arch ("bird-beaking") can lead to endoleak and graft collapse after thoracic endovascular aortic repair. We report the first United States experience with the new TX2 Pro-Form (Cook Inc, Bloomington, Ind), a novel delivery system that became commercially available in October 2009, designed to enhance circumferential apposition of the TX2 thoracic endograft to the arch. METHODS: This was a single-institution retrospective study. Endograft-to-arch conformance was quantitatively analyzed using intraoperative angiograms of consecutive, reverse chronologic cohorts of TX2 Pro-Form, TX2 Z-Trak (prior delivery system; Cook), and Gore TAG (W.L. Gore and Assoc, Flagstaff, Ariz). Only native aortic arch deployments in zones 2 and 3 were included. RESULTS: During a 6-week period, 20 Pro-Form cases were performed, of which 17 patients met inclusion criteria. These were compared with 17 Z-Trak and 17 TAG patients. Endografts were successfully delivered to their intended proximal landing zones in all 51 patients. A higher proportion of dissections were treated in the Z-Trak (65%) and TAG (76%) patients (P = .03), but similar rates of zone 2/3 deployments (P = .30). Despite the mean arch angle being greatest for the Pro-Form patients (90° vs 74° vs 71°, P = .18), the mean separation between the leading endograft edge and the aortic wall along the inner curvature of the arch was significantly less (1.4 vs 4.1 vs 5.7 mm; P = .0002), with complete apposition achieved in 65% of Pro-Form patients (18% Z-Trak, 6% TAG, P < .0001). This resulted in the lowest reduction in aortic luminal diameter at the proximal landing zone (5.5% vs 13.4% vs 19.3%; P = .0006) compared with Z-Trak and TAG. Rates of type Ia endoleak were similar (P = .38). CONCLUSIONS: The Pro-Form delivery system significantly improves endograft conformation to the arch, resulting in minimum bird-beaking even in severely angulated anatomies. |
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Authors:
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W Anthony Lee; Tomas D Martin; Philip J Hess; Thomas M Beaver; Charles T Klodell |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of vascular surgery Volume: 52 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-14 Completed Date: 2011-04-06 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1459-63 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Christine E. Lynn Heart and Vascular Institute, Boca Raton, FL 33431, USA. walee@sapbc.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aorta, Thoracic*
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radiography Aortic Aneurysm, Thoracic / radiography, surgery* Blood Vessel Prosthesis* Blood Vessel Prosthesis Implantation / instrumentation, methods* Endovascular Procedures* Humans Prosthesis Design |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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