Document Detail


Sizing Fenestrated Aortic Stent-grafts.
MedLine Citation:
PMID:  21112799     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Fenestrated aortic stent-grafts are increasingly being used to treat patients with juxtarenal abdominal aortic aneurysms (AAA). Sizing of these stent-grafts is critical to ensure success and requires detailed expert assessment of aortic morphology. At present little is known about how sizing of these stent-grafts varies between observers and the necessary tolerances involved to ensure a successful procedure.
METHODS: CT scans of 19 consecutive patients with juxtarenal aortic aneurysms that underwent successful endovascular repair with fenestrated stent-grafts were selected. Sizing of fenestrated aortic stent-grafts was performed independently by four experienced endovascular surgeons and results were compared. Data from the stent-graft manufacturer was available for comparison in 12 cases.
RESULTS: All observers agreed on the number of fenestrations; 16 devices had 3 fenestrations and 3 had 4. The overall inter-observer measurement error for all target vessel orientation was ±12.6° (10.8-14.4 95% CI), and for distance between target vessels ±5.3 mm (4.4-6.2 95% CI). The median difference in internal stent-graft diameter was 1 stent size. Agreement on fenestration type ranged from (84-95%). Comparison was performed with the manufactured stent-graft in 12 cases. The overall mean difference of target vessel orientation between the manufactured devices and the four observers was -1.3° (SD ± 6.9,-3.8-1.2 95% CI). There was less agreement between observers and device manufacturers on body and limb lengths and distal limb diameters.
CONCLUSIONS: There was generally a high level of agreement between experienced endovascular surgeons in sizing the fenestrated stent component. There were differences in component lengths but these could have been accommodated by varying the degree of overlap between components.
Authors:
A H Malkawi; T A Resch; M J Bown; B J Manning; J D Poloniecki; I M Nordon; I M Loftus; M M Thompson; R J Hinchliffe
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Publication Detail:
Type:  Journal Article     Date:  2010-11-26
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  41     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  311-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
St George's Vascular Institute, 4th Floor, St James Wing, St George's Healthcare NHS Trust, Blackshaw Road, London SW17 0QT, UK.
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