Stent grafts for aortic aneurysms: the next interventional challenge

Area of Science:

• Vascular Surgery
• Medical Devices
• Endovascular Interventions

Background:

• Stent grafts (endografts) are utilized for endoluminal exclusion of peripheral and aortic aneurysms.
• Their application extends to occlusive vascular disease and post-surgical complications.
• Ongoing clinical trials evaluate diverse endograft designs, including unsupported and supported (endo/exoskeleton) types.

Purpose of the Study:

• To review the current applications and emerging technologies of endovascular grafts.
• To highlight the procedural requirements and potential benefits of endovascular grafting.
• To identify areas for improvement in next-generation endograft devices.

Main Methods:

• Review of current clinical trials and device evaluations for endovascular grafts.
• Discussion of endograft delivery systems, including percutaneous approaches.
• Emphasis on the critical role of advanced imaging (CT, angiography) for pretreatment planning.

Main Results:

• Endovascular grafts can be delivered via minimally invasive techniques, including small arteriotomies and percutaneous access.
• Unsupported grafts demonstrate efficacy despite potential challenges like kinking.
• Modular designs allow for complex reconstructions and extensions.

Conclusions:

• Endovascular grafting offers potential advantages such as reduced hospital stay, less invasive procedures, and lower morbidity/mortality.
• Sophisticated imaging and planning are crucial for successful endovascular graft procedures.
• Further development is required to address unresolved issues in newer endograft generations.