Advanced endografting techniques: snorkels, chimneys, periscopes, fenestrations, and branched endografts

Cardiovascular Diagnosis and Therapy
Kartik KansagraCuong Lam

Abstract

The anatomy of aortic aneurysms from the proximal neck to the access vessels may create technical challenges for endovascular repair. Upwards of 30% of patients with abdominal aortic aneurysms (AAA) have unsuitable proximal neck morphology for endovascular repair. Anatomies considered unsuitable for conventional infrarenal stent grafting include short or absent necks, angulated necks, conical necks, or large necks exceeding size availability for current stent grafts. A number of advanced endovascular techniques and devices have been developed to circumvent these challenges, each with unique advantages and disadvantages. These include snorkeling procedures such as chimneys, periscopes, and sandwich techniques; "homemade" or "back-table" fenestrated endografts as well as manufactured, customized fenestrated endografts; and more recently, physician modified branched devices. Furthermore, new devices in the pipeline under investigation, such as "off-the-shelf" fenestrated stent grafts, branched stent grafts, lower profile devices, and novel sealing designs, have the potential of solving many of the aforementioned problems. The treatment of aortic aneurysms continues to evolve, further expanding the population of patients that can b...Continue Reading

Citations

Apr 1, 2020·Frontiers in Bioengineering and Biotechnology·Carlos A LabarrereGhassan S Kassab
Oct 13, 2020·Seminars in Interventional Radiology·Ann C Gaffey, Scott M Damrauer
Nov 7, 2020·Journal of Vascular Surgery·John F CharitableThomas S Maldonado
Jun 11, 2021·Acta Radiologica·Ansan JosephDivyesh Dandhaniya
Jun 8, 2021·Jornal Vascular Brasileiro·Claudia Guimarães AgleDejean Sampaio Amorim
Jul 1, 2021·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Britt W C M WarmerdamJan van Schaik
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