Physician modification of Gore C3 excluder endograft for treatment of abdominal aortic aneurysms anatomically unsuitable for conventional endovascular repair
Until recently, the Cook Zenith aortic endograft (Cook Medical Inc, Bloomington, Ind) was the only device used for physician-modified fenestration because its constraining wire allowed physicians to reconstrain the device after modifications. Although the Cook Zenith fenestrated endograft has been a...
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Published in | Journal of vascular surgery Vol. 59; no. 6; pp. 1739 - 1743 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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Mosby, Inc
01.06.2014
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Abstract | Until recently, the Cook Zenith aortic endograft (Cook Medical Inc, Bloomington, Ind) was the only device used for physician-modified fenestration because its constraining wire allowed physicians to reconstrain the device after modifications. Although the Cook Zenith fenestrated endograft has been approved by the Food and Drug Administration, it is currently not available in the majority of the hospitals and is not applicable to the patients who need urgent or emergent aneurysm repair. With the redesign of the Gore C3 delivery system, the Gore Excluder aortic stent graft (W. L. Gore & Associates, Inc, Flagstaff, Ariz) can now also be reconstrained, which makes it suitable for physician-modified fenestration. We describe the technique for modification and implantation of the Gore Excluder aortic stent graft in a patient requiring 2-vessel bilateral renal artery fenestration. This application provides an additional option for treatment of patients with abdominal aortic aneurysms who are anatomically unsuitable for conventional endovascular aneurysm repair and are at high risk for open repair. |
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AbstractList | Until recently, the Cook Zenith aortic endograft (Cook Medical Inc, Bloomington, Ind) was the only device used for physician-modified fenestration because its constraining wire allowed physicians to reconstrain the device after modifications. Although the Cook Zenith fenestrated endograft has been approved by the Food and Drug Administration, it is currently not available in the majority of the hospitals and is not applicable to the patients who need urgent or emergent aneurysm repair. With the redesign of the Gore C3 delivery system, the Gore Excluder aortic stent graft (W. L. Gore & Associates, Inc, Flagstaff, Ariz) can now also be reconstrained, which makes it suitable for physician-modified fenestration. We describe the technique for modification and implantation of the Gore Excluder aortic stent graft in a patient requiring 2-vessel bilateral renal artery fenestration. This application provides an additional option for treatment of patients with abdominal aortic aneurysms who are anatomically unsuitable for conventional endovascular aneurysm repair and are at high risk for open repair. Until recently, the Cook Zenith aortic endograft (Cook Medical Inc, Bloomington, Ind) was the only device used for physician-modified fenestration because its constraining wire allowed physicians to reconstrain the device after modifications. Although the Cook Zenith fenestrated endograft has been approved by the Food and Drug Administration, it is currently not available in the majority of the hospitals and is not applicable to the patients who need urgent or emergent aneurysm repair. With the redesign of the Gore C3 delivery system, the Gore Excluder aortic stent graft (W. L. Gore & Associates, Inc, Flagstaff, Ariz) can now also be reconstrained, which makes it suitable for physician-modified fenestration. We describe the technique for modification and implantation of the Gore Excluder aortic stent graft in a patient requiring 2-vessel bilateral renal artery fenestration. This application provides an additional option for treatment of patients with abdominal aortic aneurysms who are anatomically unsuitable for conventional endovascular aneurysm repair and are at high risk for open repair. |
Author | Zhang, Wayne W., MD Coulter, Amy H., MD Tan, Tze-Woei, MD |
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References_xml | – volume: 50 start-page: 730 year: 2009 end-page: 737 ident: bib5 article-title: Intermediate results of a United States multicenter trial of fenestrated endograft repair for juxtarenal abdominal aortic aneurysms publication-title: J Vasc Surg contributor: fullname: Bharadwaj – volume: 38 start-page: 990 year: 2003 end-page: 996 ident: bib4 article-title: Should patients with challenging anatomy be offered endovascular aneurysm repair? publication-title: J Vasc Surg contributor: fullname: Hampton – volume: 155 start-page: 1998 year: 1995 end-page: 2004 ident: bib3 article-title: Perioperative mortality of elective abdominal aortic aneurysm surgery: a clinical prediction rule based on literature and individual patient data publication-title: Arch Intern Med contributor: fullname: Habbema – volume: 57 start-page: 832 year: 2013 end-page: 833 ident: bib10 article-title: Advisory statement on clinical use of modified aortic endografts from the Society for Vascular Surgery publication-title: J Vasc Surg contributor: fullname: White – volume: 24 start-page: 980 year: 2010 end-page: 984 ident: bib9 article-title: Diameter-reducing wire to facilitate deployment of a modified Zenith fenestrated stent graft publication-title: Ann Vasc Surg contributor: fullname: Oderich – volume: 34 start-page: 1050 year: 2001 end-page: 1054 ident: bib2 article-title: Impact of exclusion criteria on patient selection for endovascular abdominal aortic aneurysm repair publication-title: J Vasc Surg contributor: fullname: Velazquez – volume: 50 start-page: 722 year: 2009 end-page: 729 ident: bib1 article-title: Age-related trends in utilization and outcome of open and endovascular repair for abdominal aortic aneurysm in the United States, 2001-2006 publication-title: J Vasc Surg contributor: fullname: Dale – volume: 21 start-page: 157 year: 2009 end-page: 167 ident: bib7 article-title: Modified fenestrated stent grafts: device design, modifications, implantation, and current applications publication-title: Perspect Vasc Surg Endovasc Ther contributor: fullname: Ricotta – volume: 56 start-page: 601 year: 2012 end-page: 607 ident: bib8 article-title: Physician-modified endovascular grafts for the treatment of elective, symptomatic, or ruptured juxtarenal aortic aneurysms publication-title: J Vasc Surg contributor: fullname: Starnes – volume: 39 start-page: 529 year: 2010 end-page: 536 ident: bib6 article-title: Fenestrated stent grafting for short-necked and juxtarenal abdominal aortic aneurysm: an 8-year single-centre experience publication-title: Eur J Vasc Endovasc Surg contributor: fullname: Prins – volume: 50 start-page: 730 year: 2009 ident: 10.1016/j.jvs.2013.12.027_bib5 article-title: Intermediate results of a United States multicenter trial of fenestrated endograft repair for juxtarenal abdominal aortic aneurysms publication-title: J Vasc Surg doi: 10.1016/j.jvs.2009.05.051 contributor: fullname: Greenberg – volume: 50 start-page: 722 year: 2009 ident: 10.1016/j.jvs.2013.12.027_bib1 article-title: Age-related trends in utilization and outcome of open and endovascular repair for abdominal aortic aneurysm in the United States, 2001-2006 publication-title: J Vasc Surg doi: 10.1016/j.jvs.2009.05.010 contributor: fullname: Schwarze – volume: 24 start-page: 980 year: 2010 ident: 10.1016/j.jvs.2013.12.027_bib9 article-title: Diameter-reducing wire to facilitate deployment of a modified Zenith fenestrated stent graft publication-title: Ann Vasc Surg doi: 10.1016/j.avsg.2010.05.011 contributor: fullname: Oderich – volume: 155 start-page: 1998 year: 1995 ident: 10.1016/j.jvs.2013.12.027_bib3 article-title: Perioperative mortality of elective abdominal aortic aneurysm surgery: a clinical prediction rule based on literature and individual patient data publication-title: Arch Intern Med doi: 10.1001/archinte.1995.00430180108012 contributor: fullname: Steyerberg – volume: 21 start-page: 157 year: 2009 ident: 10.1016/j.jvs.2013.12.027_bib7 article-title: Modified fenestrated stent grafts: device design, modifications, implantation, and current applications publication-title: Perspect Vasc Surg Endovasc Ther doi: 10.1177/1531003509351594 contributor: fullname: Oderich – volume: 38 start-page: 990 year: 2003 ident: 10.1016/j.jvs.2013.12.027_bib4 article-title: Should patients with challenging anatomy be offered endovascular aneurysm repair? 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SubjectTerms | Aged Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - surgery Blood Vessel Prosthesis Endovascular Procedures - methods Humans Male Prosthesis Design Stents Surgery Tomography, X-Ray Computed |
Title | Physician modification of Gore C3 excluder endograft for treatment of abdominal aortic aneurysms anatomically unsuitable for conventional endovascular repair |
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