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Published on: August 1, 2025
First experience with the new repositionable C3 excluder stent-graft
E L Verhoeven1, K Oikonomou, B Möhner
1Department of Vascular and Endovascular Surgery, Klinikum Nürnberg, Nürnberg, Germany. eric.verhoeven@klinikum-nuernberg.de.
Aim:
The Gore Excluder device is a modern third generation device that performs well. Nevertheless, the proximal deployment was not as accurate and controlled as with some other modern devices. Therefore a new deployment system was developed. This system allows to reconstrain the graft after initial deployment, with the purpose to reposition the graft for both level or orientation.
Methods:
The new system was used in 25 patients with an infrarenal abdominal aortic aneurysm. In 72% of cases the system was used to achieve a better proximal position or to facilitate catheterization of the contralateral limb. Surprisingly, the option to orientate the graft was used most.
Results:
The new deployment system worked well, and all grafts were easily repositioned to the intended final position. Additional cuffs were not required in any of the patients. Surgical mortality was nil. All patients left the hospital in good condition. There were no type I endoleaks at completion angiography neither at first computed tomography scanning.
Conclusion:
With the new deployment system it is possible to reposition the Excluder to achieve optimal fixation and sealing. A global registry has been set into place to report real life results including longer term performance of the graft.