Charles S. Thompson, MD, Virginia D. Gaxotte, MD, Julio A

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Presentation transcript:

Endoluminal stent grafting of the thoracic aorta: Initial experience with the Gore Excluder Charles S. Thompson, MD, Virginia D. Gaxotte, MD, Julio A. Rodriguez, MD, Venkatesh G. Ramaiah, MD, Mitar Vranic, DO, Rajagopalan Ravi, MD, Leanne DiMugno, MD, Shoaib Shafique, MD, Dawn Olsen, PA, Edward B. Diethrich, MD Journal of Vascular Surgery Volume 35, Issue 6, Pages 1163-1170 (June 2002) DOI: 10.1067/mva.2002.122885 Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Gore Excluder, self-expandable endoprothesis for thoracic aorta. Device is made of expanded polytetrafluoroethylene inner tube and outer nitinol exoskeleton. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Device loaded on flexible over-wire delivery system with polytetrafluoroethylene sleeve. Wire is pulled for deployment. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Graft deploys in middle first and then proceeds toward distal ends. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Aortic balloon has trilobed configuration for aortic apposition without impedance of aortic blood flow. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Preoperative angiogram (A) and CT scan (B) show 7-cm aneurysm in distal aortic arch and proximal descending thoracic aortic in 72-year-old patient. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 6 Postoperative angiogram (A) and CT scan (B) after deployment of Gore Excluder stent-graft show adequate exclusion of aneurysm described in Fig 5. Carotid subclavian bypass procedure was performed before stent placement to allow for adequate landing proximal landing zone. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 7 Reconstructed preoperative angiogram (A) shows acute dissection of thoracic aorta in 77-year-old man with chest pain. Patient had previous thoracic aortic aneurysm and abdominal aortic aneurysm repair. Schematic overlay (B) of angiogram shows wire fenestration of dissection to maintain renal arterial flow. Schematic overlay (C) after endoluminal stent-graft placement into true lumen with exclusion of dissection at thoracic level but with allowance of retrograde filling to level of renal arteries after fenestration. Journal of Vascular Surgery 2002 35, 1163-1170DOI: (10.1067/mva.2002.122885) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions