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Configuration affects parallel stent grafting results.

Adam Tanious1, Mathew Wooster1, Paul A Armstrong1

  • 1Division of Vascular Surgery, USF Health Morsani School of Medicine, Tampa, Fla.

Journal of Vascular Surgery
|November 21, 2017
PubMed
Summary
This summary is machine-generated.

Optimal parallel stent graft configuration for complex aortic diseases involves specific oversizing and antegrade placement. Avoiding <10% main body oversizing reduces endovascular aneurysm repair (EVAR) complications and mortality risks.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Complex aortic diseases often require adjunctive endovascular repair strategies.
  • Off-the-shelf parallel stent graft solutions offer a standardized approach to complex aortic pathologies.

Purpose of the Study:

  • To evaluate parallel stent graft configurations for complex aortic diseases.
  • To determine an optimal formula for parallel stent graft procedures in treating aortic diseases.

Main Methods:

  • Retrospective review of 78 patients treated with parallel stent grafts between January 2010 and September 2015.
  • Analysis of outcomes based on graft orientation, type, main body device, and oversizing.
  • Primary endpoints included parallel stent graft compromise and overall endovascular aneurysm repair (EVAR) compromise.

Main Results:

  • A significant correlation exists between main body oversizing and snorkel compromise (P = .0195) and overall procedural complication (P = .0019).
  • Main body oversizing <10% was associated with the highest rate of overall EVAR complication (73%; P = .0003).
  • Antegrade configurations demonstrated a lower complication rate compared to retrograde configurations, with optimal oversizing >20%.

Conclusions:

  • Parallel stent grafting is a viable off-the-shelf option for various aortic diseases.
  • Suboptimal main body oversizing (<10%) increases the risk of parallel stent and overall EVAR compromise.
  • Antegrade configurations are preferred over retrograde configurations for improved outcomes, with optimal oversizing exceeding 20%.