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Branched and Fenestrated Devices for Treatment of Juxtarenals and Thoracoabdominal Aneurysms

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Vascular Surgery

Abstract

The juxtarenal and the thoracoabdominal aortic aneurysm (TAAA) are chronic degenerative disease whose natural history usually involves structural progressive deterioration of the vessel wall, with gradual expansion and eventual rupture. Aneurysm rupture is the major complication with disastrous consequences. The history of this disease has reflected the remarkable progress of vascular and endovascular surgery over the years. The real possibility of transforming a major surgery in a minimally invasive procedure seduced experts and produced profound conceptual changes with a constant search on improving the techniques, the material and achieving better results. The complexity of the anatomy of these aneurysms, limit the development of endovascular solutions. However, some different fenestrated and branched devices and techniques have been successfully used.

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References

  1. Jongkind V, Yeung KK, Akkersdijk GJM, Heidsieck D. Juxtarenal aortic aneurysm repair. J Vasc Surg. 2010;52:760–7.

    Article  PubMed  Google Scholar 

  2. Bruen KJ, Feezor RJ, Daniels MJ, Beck AW, Lee WA. Endovascular chimney technique versus open repair of juxtarenal and suprarenal aneurysms. J Vasc Surg. 2011;53:895–905.

    Article  PubMed  Google Scholar 

  3. Knott AW, Kalra M, Duncan AA, Reed NR, Bower TC, Hoskin TL, Oderich G, Gloviczki P. Open repair of juxtarenal aortic aneurysms (JAA) remains a safe option in the era of fenestrated endografts. J Vasc Surg. 2008;47:695–701.

    Article  PubMed  Google Scholar 

  4. Schanzer A, Greenberg RK, Hevelone N, Robinson WP, Eslami MH, Goldberg JH, Messina L. Predictors of abdominal aortic aneurysm sac enlargement after endovascular repair. Circulation. 2011;123:2848–55.

    Article  PubMed  Google Scholar 

  5. Bungay PM, Burfitt N, Sritharan K, Muir L, Khan SL, De Nunzio MC, Lingam K, Davies HA. Initial experience with a new fenestrated stentgraft. J Vasc Surg. 2011;54(6):1832–8.

    Article  PubMed  Google Scholar 

  6. Lobato AC, Pereira AP, Colli Jr DP, Ristow AV. Cirurgia endovascular, vol. 2. São Paulo: Instituto de Cirurgia Vascular e Endovascular de São Paulo; 2010.

    Google Scholar 

  7. Espinoza G, Marchiori E, Araújo AP, Caramalho MF, Barzola P. Estudo morfométrico da aorta abdominal para tratamento endovascular dos aneurismas aórticos: comparação entre tomografia helicoidal e angiografia. Rev Bras Cir Cardiovasc. 2002;17(4):323–30.

    Google Scholar 

  8. Greenberg RK, Clairn D, Srivastava S, Bhandari G, Turc A, Hampton J, Popa M, Green R, Ouriel K. Should patients with challenging anatomy be offered endovascular aneurysm repair? J Vasc Surg. 2003;38:990–6.

    Article  PubMed  Google Scholar 

  9. Donas KP, Eisenack M, Panuccio G, Austermann M, Osada N, Torsello G. The role of open and endovascular treatment with fenestrated and chimney endografts for patients with juxtarenal aortic aneurysms. J Vasc Surg. 2012;56:285–90.

    Article  PubMed  Google Scholar 

  10. Ohrlander T, Sonesson B, Ivancev K, Resch T, Dias N, Malina M. The chimney graft: a technique for preserving or rescuing aortic branch vessels in stent-graft sealing zones. J Endovasc Ther. 2008;15:427–32.

    Article  PubMed  Google Scholar 

  11. Lee JT, Greenberg JI, Dalman RL. Early experience with the snorkel technique for juxtarenal aneurysms. J Vasc Surg. 2012;55:935–46.

    Article  PubMed  Google Scholar 

  12. Lobato AC, Lobato LC. Endovascular treatment of complex aortic aneurysms using the sandwich technique. J Endovasc Ther. 2012;19:691–706.

    Article  PubMed  Google Scholar 

  13. Kasirajan K. Branched grafts for thoracoabdominal aneurysms: off-label use of FDA-approved devices. J Endovasc Ther. 2011;18(6):A-5.

    Article  Google Scholar 

  14. Silveira PG, Galego GN, Bortoluzzi CT, Franklin RN. Re: “branched grafts for thoracoabdominal aneurysms: off-label use of FDA-approved devices”. J Endovasc Ther. 2012;19:130.

    Article  PubMed  Google Scholar 

  15. Vemuri C, Woo E, Fajardo A, Farber MA, Lee J, Oderich G, Sanchez LA. Post-approval outcomes of juxtarenal aortic aneurysms treated with the Zenith fenestrated endovascular graft. J Vasc Surg. 2013;58:1434.

    Article  Google Scholar 

  16. Dijkstra ML, Tielliu IFJ, Meerwaldt R, Pierie M, van Brussel J, Schurink GWH, Lardenoye JW, Zeebregts CJ. Dutch experience with the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair. J Vasc Surg. 2014;60(2):301–7.

    Article  PubMed  Google Scholar 

  17. Oderich GS, Ricotta JJ. Modified fenestrated stent grafts: device design, modifications, implantation, and current applications. Perspect Vasc Surg Endovasc Ther. 2009;21(3):157–67.

    Article  PubMed  Google Scholar 

  18. Anderson J, Nykamp M, Danielson L, Remund T, Kelly PW. A novel endovascular debranching technique using physician-assembled endografts for repair of thoracoabdominal aneurysms. J Vasc Surg. 2014;60:1177–85.

    Article  PubMed  Google Scholar 

  19. Resch TA, Dias NV, Sobocinski J, Sonesson B, Roeder B, Haulon S. Development of off-the-shelf stent grafts for juxtarenal abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2012;43(6):655–60.

    Article  CAS  PubMed  Google Scholar 

  20. Bosiers MJ, Bisdas T, Donas KP, Torsello G, Austermann M. Early experience with the first commercially available off-the-shelf multibranched endograft (t-branch) in the treatment of thoracoabdominal aortic aneurysms. J Endovasc Ther. 2013;20(6):719–25.

    Article  PubMed  Google Scholar 

  21. Bisdas T, Donas KP, Bosiers MJ, Torsello G, Austermann M. Custom-made versus off-the-shelf multibranched endografts for endovascular repair of thoracoabdominal aortic aneurysms. J Vasc Surg. 2014;60(5):1186–95. doi:10.1016/j.jvs.2014.06.003.

    Article  PubMed  Google Scholar 

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Correspondence to Pierre Galvagni Silveira .

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Silveira, P.G., Franklin, R.N., do Nascimento Galego, G., Bortoluzzi, C.T., de Melo Soares, R.B. (2017). Branched and Fenestrated Devices for Treatment of Juxtarenals and Thoracoabdominal Aneurysms. In: Dardik, A. (eds) Vascular Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-33745-6_8

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  • DOI: https://doi.org/10.1007/978-3-319-33745-6_8

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