Sheath-assisted controlled deployment technique for Excluder bifurcated main body

Area of Science:

• Endovascular surgery
• Medical device technology
• Vascular repair

Background:

• The W. L. Gore Excluder bifurcated device is used for endovascular aneurysm repair.
• Predicting the deployment angle can be challenging in certain proximal neck anatomies.
• This can lead to suboptimal device landing below the renal arteries.

Purpose of the Study:

• To describe a novel technique for controlled deployment of the Excluder device.
• To improve device positioning in challenging proximal neck anatomies.
• To ensure accurate landing below the renal arteries.

Main Methods:

• A "flowering" technique is described, involving slow pulling of the deployment string.
• An introducer sheath is used to buttress the device during deployment.
• This allows for controlled longitudinal positioning and prevents premature deployment.

Main Results:

• The technique facilitates gradual deployment of the Excluder device.
• It allows for precise longitudinal positioning of the stent-graft.
• It is particularly useful in angulated or short proximal necks.

Conclusions:

• The described "flowering" technique offers enhanced control during Excluder device deployment.
• This method can improve procedural success rates in complex aortic neck anatomies.
• It provides a valuable option for surgeons facing challenging proximal neck conditions.