Technique of implantation and bail-out maneuvers for endovascular fenestrated repair of juxtarenal aortic aneurysms

• Published in: Perspectives in vascular surgery and endovascular therapy Vol. 25; no. 1-2; p. 28
• Main Authors: Oderich, Gustavo S, Mendes, Bernardo C, Kanamori, Karina S
• Format: Journal Article
• Language: English
• Published: United States 01.06.2013
• Subjects: Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - surgery; Aortography - methods; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - methods; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Endovascular Procedures - methods; Humans; Prosthesis Design; Stents; Tomography, X-Ray Computed; Treatment Outcome; endovascular; abdominal aortic aneurysm; fenestrated; juxtarenal
• ISSN: 1521-5768
• DOI: 10.1177/1531003513512372

Endovascular repair of complex aneurysms involving the visceral arteries has become a reality. Fenestrated endovascular aortic repair (FEVAR) has been used with increasing frequency to treat complex aortic aneurysms. The Zenith fenestrated stent-graft system (Cook Medical Inc, Brisbane, Australia) was approved for commercial use in the United States in April 2012, offering a custom-made design with up to 3 fenestrations to treat short-neck infrarenal and juxtarenal abdominal aortic aneurysms. Nevertheless, FEVAR is a complex procedure that demands accurate planning, advanced endovascular skills, and excellent perioperative patient care to achieve optimal outcomes. This article summarizes the basic concepts of device design, case planning, techniques of implantation, and some of the "bail-out" maneuvers that may be required during endovascular repair using the Zenith fenestrated stent-graft system.