TY - JOUR
T1 - Technical tips for endovascular aortic repair using the Gore Excluder abdominal stent-graft
T2 - Endo-wedge technique and scrum technique
AU - Banno, Tatsuo
AU - Kato, Ryoichi
AU - Hanaoka, Ryota
AU - Akamatsu, Hokuto
AU - Kaneko, Kan
AU - Toyama, Hiroshi
PY - 2014
Y1 - 2014
N2 - When performing endovascular aortic repair (EVAR) procedures, clinicians sometimes encounter cases in which the indications for EVAR are beyond the instruction for use (IFU). In EVAR, proximal neck fixation is the most important factor. This report describes several techniques and tips for EVAR in cases presenting with a difficult short neck or angled neck, especially when using the Gore Excluder®. Endo-wedge techniques (EWT), including non-sheath-assisted EWT with sheath-assisted strategies, are presented. We describe the scrum technique, which is a special procedure that is only feasible when using the Gore Excluder®. In this technique, intentional wire bending around the proximal neck portion occurs by pushing from both sides of the guidewire. This technique is applicable in cases with a sharply angled neck. The scrum with EWT is a more precise strategy for cases with a short or angled neck. Other troublesome cases include limb occlusion caused by weak points in the Gore Excluder® body and legs. The very rare complication of stent-graft collapse is also reviewed.
AB - When performing endovascular aortic repair (EVAR) procedures, clinicians sometimes encounter cases in which the indications for EVAR are beyond the instruction for use (IFU). In EVAR, proximal neck fixation is the most important factor. This report describes several techniques and tips for EVAR in cases presenting with a difficult short neck or angled neck, especially when using the Gore Excluder®. Endo-wedge techniques (EWT), including non-sheath-assisted EWT with sheath-assisted strategies, are presented. We describe the scrum technique, which is a special procedure that is only feasible when using the Gore Excluder®. In this technique, intentional wire bending around the proximal neck portion occurs by pushing from both sides of the guidewire. This technique is applicable in cases with a sharply angled neck. The scrum with EWT is a more precise strategy for cases with a short or angled neck. Other troublesome cases include limb occlusion caused by weak points in the Gore Excluder® body and legs. The very rare complication of stent-graft collapse is also reviewed.
KW - Abdominal aortic aneurysm (AAA)
KW - Aortic stent graft
KW - Endo-wedge technique (EWT)
KW - Endovascular aortic repair (EVAR)
KW - Excluder
KW - Guiding catheter (GC)
KW - Scrum technique
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U2 - 10.2174/1874347101408010008
DO - 10.2174/1874347101408010008
M3 - Article
AN - SCOPUS:84896820151
SN - 1874-3471
VL - 8
SP - 8
EP - 21
JO - Open Medical Imaging Journal
JF - Open Medical Imaging Journal
IS - 1
ER -