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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Thoracoabdominal aneurysm repair using the Unitary Manifold Device.

Cole D Tessendorf1, Andrew Holmes1, Spencer J Lucas1

  • 1University of South Dakota Sanford School of Medicine, Sioux Falls, SD.

Journal of Vascular Surgery
|March 29, 2024
PubMed
Summary

The physician-modified Unitary Manifold (UM) device achieved high technical success for endovascular repair of thoracoabdominal aortic aneurysms in 126 patients. This study highlights its effectiveness and safety in a diverse patient population.

Keywords:
Aortic aneurysmEndovascular repairThoracoabdominal

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Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Aortic Aneurysm Treatment

Background:

  • Thoracoabdominal aortic aneurysms (TAAA) present complex treatment challenges.
  • Endovascular repair offers a less invasive alternative to open surgery.
  • Physician-modified devices allow for tailored treatment of complex anatomies.

Purpose of the Study:

  • To evaluate the safety and efficacy of the physician-modified, nonanatomic-based Unitary Manifold (UM) device for TAAA repair.
  • To assess outcomes in a consecutive series of all-comer patients treated with the UM device.
  • To report technical success, adverse events, and long-term patency rates.

Main Methods:

  • Prospective, single-center study of 126 consecutive patients undergoing TAAA repair with the UM device (2015-2023).
  • Inclusion of all-comer patients regardless of aneurysm extent, presentation, or prior spinal cord events.
  • Data collection on technical success, major adverse events, reinterventions, patency, and mortality.

Main Results:

  • High technical success rate of 99.2% (125/126 patients).
  • Low reintervention rates for limb patency (2.4%) and overall reintervention (5.6%) at 365 days.
  • Respiratory failure was the most common major adverse event (13.5% at 365 days); one case of persistent paraplegia (0.8%).
  • No device integrity failures or conversions to open repair were observed.

Conclusions:

  • The UM device demonstrates excellent technical success, treatment success, and device patency in TAAA repair.
  • Acceptable rates of major adverse events and reinterventions were observed in this diverse, all-comer patient cohort.
  • This study represents a broad patient population, offering valuable insights compared to studies using off-the-shelf devices.