Purpose
Endovascular stentgraft treatment of the ascending aorta is feasible in special indications.
The purpose of this investigation was to evaluate a novel stentgraft design in phantoms,
cadavers and one clinical patient.
Methods and Materials
A stentgraft was designed specifically for the application in the ascending aorta.
This includes the fixation of the apices facing the inner curvature with metal levers from distally,
thereby eliminating the forward movement that previous designs have shown due to apix fixation near the nose cone.
The device was deployed in three aortic phantoms and four cadavers.
The distance between the actual and the intended landing position along the inner and outer curvatures was recorded.
Ultimately,
the device was implanted in a patient suffering from...
Results
The stentgrafts were successfully deployed in all phantoms and cadavers.
In one cadaver,
the nose cone could not be advanced proximally enough to place the stentgraft in the intended landing zone.
The stentgraft was intentionally placed 15mm distally to the intended landing zone.
The total error range in placing the proximal stentgraft end was within 1mm proximal and 14mm distal to the intended landing zone on the inner curvature,
and between 2 and 8 mm distal to the intended landing zone of the outer curvature....
Conclusion
The novel stentgraft design allows for safe and precise placement of the stentgraft into the ascending aorta.
However,
a proximal and distal landing zone of ca.2cm each is necessary for safe and effective placement.
Stentgraft therapy of the ascending aorta is reserved for selected indications only,
where it represents a complementary,
but not concurrent,
alternative to open surgery.
References
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Endovascular aortic arch repair: hopes and certainties.
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Zimpfer D,
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Funovics M,
Dorfmeister M,
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Marta G,
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Grimm M.
Endovascular stent-graft placement of aneurysms involving the descending aorta originating from chronic type B dissections.
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