Document Detail


Thoracic aortic stent-graft devices: problems, failure modes, and applicability.
MedLine Citation:
PMID:  17580245     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Optimal treatment strategies for pathologies of the descending thoracic aorta are still controversial. Open surgery is complex, while endovascular devices allow nonsurgical access to the thoracic aorta. Endografts can be inserted via a peripheral artery while maintaining aortic blood flow without any need for clamping. Both short- and mid-term outcomes after endografting thoracic aneurysm and type B aortic dissection are encouraging, with significantly lower morbidity and early mortality compared with open surgery. However, despite emerging popularity and growing interest as an alternative to surgery, endograft design and manufacturing have not kept pace with growing clinical ambition. Major challenges associated with endovascular procedures using the current generation of endografts range from the relative rigidity and size of the delivery system to the failure of thoracic endografts to conform snugly to the anatomy of the aortic arch. Nonconformity of grafts may lead to graft instability, endoleak, and procedural failure. Current delivery systems are potentially traumatizing and, at times, too inflexible to track through tortuous, calcified vessels, and often require surgical exposure of the access vessel. Although efforts have been made by the industry to improve conformability and fixation in the aortic arch, given the spiraling movement of the thoracic aorta with each ventricular contraction, much work needs to be done on miniaturization and creation of disease-specific devices. The aim of this work is to give an overview on thoracic aortic stent-graft devices with focus on problems, failure modes and potential improvements.
Authors:
Christoph A Nienaber; Stephan Kische; Hüseyin Ince
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in vascular surgery     Volume:  20     ISSN:  0895-7967     ISO Abbreviation:  Semin Vasc Surg     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-20     Completed Date:  2007-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809602     Medline TA:  Semin Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University Hospital Rostock, Rostock School of Medicine, Rostock, Germany. christoph.nienaber@med.uni-rostock.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, Dissecting / pathology,  radiography,  surgery*
Aortic Aneurysm, Thoracic / pathology,  radiography,  surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Female
Humans
Male
Middle Aged
Prosthesis Design
Prosthesis Failure*
Stents*
Treatment Outcome

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


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