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ludc webb

Nuno Dias

Associate professor

ludc webb

In situ bending of thoracic stent grafts: Clinical application of a novel technique to improve conformance to the aortic arch.

Author

  • Tilo Kölbel
  • Nuno Dias
  • Tim Resch
  • Jan Holst
  • Björn Sonesson
  • Martin Malina

Summary, in English

PURPOSE: A straight thoracic stent graft often complies poorly with the curvature of the aortic arch. We have previously reported an in vitro model of a modified stent graft that can be bent in situ after deployment to improve conformance to the aortic arch. We now report the first clinical experience with this technique in three consecutive patients. METHODS: Between September 2007 and August 2008, three patients were treated for different pathologies of the aortic arch with a modified thoracic stent graft that was fitted with a sliding self-locking knot and a detachable Bowden cable. Transfemoral traction on the Bowden cable enables controlled shortening of the proximal part of the stent graft at the inner curve after deployment. The stent graft is thereby directed to allow for better apposition to the aortic wall. RESULTS: The modified thoracic stent grafts were correctly orientated and deployed in all patients. Transfemoral traction on the Bowden cable successfully bent all stent grafts and improved vessel wall apposition without a residual gap on the inner curve. The Bowden cable was successfully released and withdrawn in all patients. CONCLUSION: In situ bending of thoracic stent grafts with a sliding self-locking knot is feasible and improves proximal apposition of the device at the inner curve of the aortic arch. More data and longer follow-up are required to confirm the applicability of this technique.

Department/s

  • Department of Clinical Sciences, Malmö
  • Vascular Diseases - Clinical Research

Publishing year

2009

Language

English

Pages

1613-1616

Publication/Series

Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter

Volume

49

Document type

Journal article

Publisher

Mosby

Topic

  • Cardiac and Cardiovascular Systems

Status

Published

Research group

  • Vascular Diseases - Clinical Research

ISBN/ISSN/Other

  • ISSN: 1097-6809