OUTCOMES OF ENDOVASCULAR TAAA REPAIR
|
|
|
- Amie Norman
- 5 years ago
- Views:
Transcription
1 OUTCOMES OF ENDOVASCULAR TAAA REPAIR Gustavo S. Oderich MD Professor of Surgery Director of Aortic Center Director of Advanced Endovascular Aortic Program Division of Vascular and Endovascular Surgery T H E H O U S T O N A O R T I C S Y M P O S I U M
2 FACULTY DISCLOSURES Consulting* Cook Medical Inc., WL Gore, GE Healthcare Research grants* Cook Medical Inc., WL Gore, GE Healthcare Investigational, off-label use of devices Cook Fenestrated and Branched Grafts, Gore Branched Technology * All consulting fees and research educations grants paid to Mayo Clinic
3 1,896 TAAA REPAIRS Estrera A (Safi H) et al. Ann Surg 2015;262(4):600-8 Mean age, 64 years-old 30-day mortality: - All patients: 15.9% - Normal egfr: 5.2% Major adverse events - Dialysis, 16.6% - Stroke, 5% - Spinal cord injury,9.6%
4
5 etaaa REPAIR Contemporary results of large aortic centers Author, Year n IV/I-III Mea n age 30-day mortality Kasprzak et al (2014) 83 30/ % Bisdas T et al (2015) / % Dias N et al (2015) 72 17/ % Katsargyris et al (2015) / % SCI 20 % 16 % 31 % 10 % Paraplegi a Dialysis 13% 5% 8% 21% Maurel et al (2015) / % 4% 1% 5% Eagleton et al (2016) 354 0/ % 9% 4% 3% Fernandez et al (2016) 2% / % 5% 10%
6 MOVING TARGET Learning curve: patient selection and team experience Strategies to prevent spinal cord injury Changes in device design, delivery system, and bridging stents
7 PATIENT SELECTION Genetically Triggered Aortic Diseases (GenTADs) Excessive aortic debris ( Shaggy Aorta) Unsuitable target vessel anatomy
8 No. of Patients MAYO CLINIC F-BEVAR PROGRAM 510 consecutive patients ( ) day mortality: 1.5% (8/510) Year
9 LEARNING CURVE IN 334 PATIENTS TREATED BY FENESTRATED-BRANCHED ENDOVASCULAR REPAIR FOR COMPLEX AORTIC ANEURYSMS All n = 334 Q1 n = 81 Q2 n = 84 Q3 n = 85 Q4 n = 84 P value 30 day mortality 2% 6% 2% 1% 0% Any major adverse 33% < % 32% 21% 21% event 30-day reinterventions 9% 9% 10% 6% 2% <.001 L Y O N, F R A N C E Oderich et al (unpublished data)
10 MOVING TARGET Learning curve: patient selection and team experience Strategies to prevent spinal cord injury Changes in device design, delivery system, and bridging stents
11 Proximal TEVAR 1-Stage 2-Stage P Any SCI 38% 11%.02 Permanent 16% 0%.03 Perfusion branches No TASP TASP P O Callaghan A et al. J Vasc Surg 2015 Kasprzak et al. Eur J Vasc Endovasc Surg 2014 Any SCI 23% 13%.00 1 Paraplegia 21% 3%.02
12 SPINAL CORD INJURY PREVENTION Staged aortic coverage Permissive hypertension CSF drainage hours Neuromonitoring Early limb reperfusion Selective temporary sac perfusion (TASP)
13 PATIENTS 274 patients enrolled (January 30 th, 2018) 42 patients await device implantation 232 patients had implantation with > 30-day follow up 84 pararenal (36%) 62 Extent 4 TAAA (27%) 86 Extent 1-3 TAAA (37%)
14 30-DAY RESULTS One (0.5%) 30-day or in-hospital death Overall n = 232 Pararenal n = 84 Extent IV n = 62 Extent I-III n = 86 P value Percent Any MAE 53 (23) 17 (20) 16 (26) 20 (23) 0.72 EBL >1L 20 (9) 4 (5) 5 (8) 11 (13) 0.17 egfr >50% 18 (8) 5 (6) 8 (13) 5 (6) 0.20 New-onset dialysis 3 (1) 1 (1) 1 (2) 1 (1) 0.96 Myocardial infarction 10 (4) 4 (5) 5 (8) 1 (1) 0.12 Respiratory failure 5 (2) 1 (1) 2 (3) 2 (2) 0.69 Any Spinal Cord Injury 10 (4) 1 (1) 0 9 (10) 0.05 Permanent Paraplegia 2 (1) 1 (1) 0 1 (1) 0.69 Major stroke 2 (1) 1 (1)* 1 (2) Bowel ischemia 4 (2) 3 (4) 1 (2) * Hemorrhagic, spinal drain-related
15 MOVING TARGET Learning curve: patient selection and team experience Strategies to prevent spinal cord injury Changes in device design, delivery system, and bridging stents
16 STENT DESIGNS Off-the-Shelf Cook t-branch Gore TAMBE Medtronic Jotec Patient Specific Cook platform Any design with fenestrations ± branches
17 ONE BRANCH 3 FENS TWO BRANCH 2 FENS FOUR BRANCH
18 PRE-LOADED WIRE SYSTEM
19
20 VBX BALLOON EXPANDABLE STENT Viabahn VBX Length 5, 7.5, 10-cm 39, 59, 79 mm Diameter 6-9 mm 5-9 mm Sheath profile 7-9 Fr 7-8 Fr
21 What are the state-of-theart results after overcoming the learning curve of F-BEVAR?
22 UNITED STATES FENESTRATED- BRANCHED RESEARCH CONSORTIUM T H E H O U S T O N A O R T I C S Y M P O S I U M Manuscript in preparation (unpublished data)
23 US Fenestrated and Branched Consortium 10 ongoing prospective, non-randomized physician-sponsored investigational device exemption trials UW M Sweet Mayo Clinic G Oderich UMASS A Schanzer MGH M Eagleton UCFS T Chuter Cornell D Schneider UTSW C Timaran U of Alabama A Beck UNC M Farber Boca Raton A Lee
24 US IDE CONSORTIUM Prospective, non-randomized PS-IDE study External auditing, FDA auditing Clinical Event Committee/ DSMB Independent radiological review of imaging Off-the-shelf or patient-specific fenestrated/ branched endograft devices Modern, preloaded, lower-profile designs Novel bridging stent-grafts (Viabahn, VBX) Does not include learning curve Large numbers in shorter period (True state-of-the-art contemporary experience)
25 Branch Vessel Durability After Branched and Fenestrated Endovascular Repair of Pararenal and Thoracoabdominal Aortic Aneurysms in the US IDE Experience Darren B. Schneider MD 1, Mark A. Farber MD 2, Andres Schanzer MD 3, Adam Beck MD 4, Carlos H. Timaran MD 5, Matthew P. Sweet MD 6, Emanuel Tenorio MD, PhD 7 and Gustavo S. Oderich MD 7 On behalf of the US Branched and Fenestrated IDE Consortium 1 Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, NY, 2 University of North Carolina, Chapel Hill, NC, 3 University of Massachusetts, Worcester, MA, 4 University of Alabama, Birmingham, AL 5 1 University of Texas Southwestern Medical Center, Dallas, TX, 6 University of Washington, Seattle, WA, 7 Mayo Clinic, Rochester, MN Outcomes of endovascular repair of post-dissection and degenerative thoracoabdominal Objectives To aortic report aneurysms visceral branch using outcomes fenestrated-branched after endovascular stent-grafts repair of complex aortic aneurysms with using fenestrations and directional branches. Emanuel Tenorio MD, PhD 1, Gustavo S. Oderich MD 1, Mark Farber MD 2, Darren B. Schneider MD 3, Carlos Methods Prospectively Timaran MD 4, collected Andres Schanzer data from MD 5 physician-sponsored, Adam Beck MD 6, Matthew IDE studies Sweet MD at 7 US centers (members of a US research consortium of branched and fenestrated endovascular repair for On behalf of the United States Fenestrated-Branched Research Consortium pararenal and thoracoabdominal aneurysms) were analyzed in order to evaluate visceral 1Mayo branch Clinic, outcomes. Rochester, Technical MN, 2 University success of was North defined Carolina, as Chapel successful Hill, NC, intraoperative 3 Weill Cornell cannulation Medicine, NewYork- of target Presbyterian visceral arteries; Hospital, New branch York, instability NY, 4 University was defined of Texas as South any Western, branch-related Dallas TX, 5 University of occlusion/stenosis, disconnection or type I/III endoleak. Univariate and multivariate analyses Massachusetts, were performed Worcester, to identify MA, 6 University Abstracts predictors of Alabama, of submitted loss of Birmingham, branch for patency AL, presentation 7 University or stability. of Washington, Seattle, WA B O S T O N M A Results Between 2013 to patients (mean age 73±8, 70% men) underwent branched and fenestrated endovascular repair of pararenal (N=232, 36%), type IV
26 PATIENTS 661 patients enrolled (January 1 st, 2018) All patients had implantation with > 30-day follow up 232 pararenal (36%) 221 Extent 4 TAAA (33%) 208 Extent 1-3 TAAA (31%)
27 STUDY PATIENTS Overall n = 661 Pararenal n = 232 Extent IV n = 221 Extent I-III n = 208 n (Percent) or Mean ± Standard Deviation P value Mean age (years ± SD) 73±8 75±7 72±8 73±8 <0.001 Age > 80 years old 148 (23) 74 (32) 34 (15) 40 (19) <0.001 Male gender 465 (70) 181 (78) 170 (77) 114 (55) <0.001 Cigarette smoking 500 (76) 169 (73) 181 (82) 150 (72) 0.03 Hypertension 605 (92) 206 (89) 217 (90) 199 (96) 0.02 Hypercholesterolemia 476 (80) 173 (75) 155 (79) 148 (71) 0.54 Coronary artery disease 321 (49) 115 (50) 119 (54) 87 (42) 0.04 Chronic pulmonary disease 282 (43) 96 (41) 91 (41) 95 (46) 0.57 Chronic Kidney Disease III-V 283 (44) 97 (43) 98 (46) 88 (43) 0.93 Congestive heart failure 91 (14) 27 (12) 34 (15) 30 (14) 0.48 Prior aortic repair 288 (44) 57 (25) 91 (41) 140 (68) <0.001 Diabetes mellitus 92 (14) 34 (15) 32 (14) 26 (13) 0.77 Stroke 77 (12) 27 (12) 26 (12) 24 (12) 0.99 Chronic Dissection TAAA 38 (6) 0 7 (3) 31 (15) <0.001
28 30-DAY RESULTS 30-DAY OUTCOMES Overall n = 661 Pararenal n = 232 n (Percent) Extent IV n = 221 Extent I- III n = 208 P value Any Mortality 13 (2) 3 (1) 5 (2) 5 (2) 0.82 Any MAE 97 (15) 26 (11) 33 (15) 38 (18) 0.11 EBL >1L 29 (5) 6 (3) 9 (4) 14 (7) 0.10 Acute Kidney injury 36 (5) 7 (3) 14 (6) 15 (7) 0.11 Myocardial infarction 12 (2) 4 (2) 7 (3) 1 (0.4) 0.11 Respiratory failure 20 (3) 2 (1) 10 (5) 8 (4) Paraplegia 11 (2) 1 (0.4) 1 (0.4) 9 (4) <0.001 Stroke 12 (2) 3 (1) 4 (2) 5 (2) 0.68 Bowel ischemia 22 (3) 5 (2) 10 (5) 7 (3) 0.37
29 Patient survival (%) PATIENT SURVIVAL 100 Estrera A (Safi H) et al. Ann Surg 2015;262(4): At risk (no.) 0 88±2 80±2 Mean age, 74 years-old 43% CKD Stage III to V Follow-up (years) 76± Stage I Stage II Stage III Stage IV
30 Freedom from aortic related death (%) AORTIC RELATED DEATH ± At risk (no.) Follow-up (years)
31 Freedom from target vessel instability (%) TARGET VESSEL INSTABILITY ±4 96±5 93± Any target vessel related death, rupture, occlusion or secondary intervention At risk (no.) Follow-up (years) 2,428 1,
32 Freedom from secondary intervention (%) SECONDARY INTERVENTIONS At risk (no.) 0 83±2 95% minor, endovascular 3% major, endovascular 2% major, open surgical 74± Follow-up (years) 66±
33 TREATMENT TRENDS & OUTCOMES OF OPEN VERSUS ENDOVASCULAR TAAA REPAIR IN A SINGLE CENTER Ying Huang MD PhD, Gustavo S. Oderich MD, Mauricio Ribeiro MD PhD, Thomas C. Bower MD, Alberto Pochetino MD, Manju Kalra MBBS, Randall DeMartino MD, Stephen Cha MS and Peter Gloviczki MD COPENHAGEN, DENMARK
34 Freedom from reintervention (%) AORTIC REINTERVENTION 100 No. at risk OSR F-BEVAR ± ± OSR P = F-BEVAR Year 84± ±
35 Freedom from reintervention (%) NON-AORTIC REINTERVENTION 100 No. at risk OSR F-BEVAR ± ± OSR P < F-BEVAR Year 93± ±
36 Freedom from reintervention (%) ANY REINTERVENTION 100 No. at risk OSR F-BEVAR ± ± OSR P = F-BEVAR Year 68± ±
37 CONCLUSIONS Outcomes of etaaa repair continue to improve as a reflection of team experience and adoption of specific protocols to prevent spinal cord injury The technique is safe, effective, and has the potential Unquestionably, to significantly a 71-year reduce Iraqi morbidity male and mortality compared to open surgical repair with a large TAAA and suitable anatomy should have endo TAAA repair, and not Important open considerations repair are learning curve, need for optimal imaging and familiarity with advanced endovascular techniques
38
Toward Total Endovascular Therapy of the Aorta. Adam W. Beck, MD. Associate Professor of Surgery Division of Vascular Surgery and Endovascular Therapy
Toward Total Endovascular Therapy of the Aorta Adam W. Beck, MD Associate Professor of Surgery Division of Vascular Surgery and Endovascular Therapy University of Alabama at Birmingham Disclosures Grant
Thoracoabdominal Aorta: Advances and Novel Therapies
Thoracoabdominal Aorta: Advances and Novel Therapies Robert Meisner, MD FACS Sidney Kimmel Medical Center Assistant Professor of Surgery Vascular / Endovascular Surgeon at Lankenau Medical Center November
Endoleaks after F-BEVAR How to Assess & Treat? Gustavo S. Oderich, MD Mayo Clinic Rochester, MN
Endoleaks after F-BEVAR How to Assess & Treat? Gustavo S. Oderich, MD Mayo Clinic Rochester, MN FACULTY DISCLOSURE Gustavo S. Oderich MD Consulting, DSMB, CEC* Cook Medical Inc., WL Gore, Lombardi Honoraria
What is the benefit. of MEP s in BEVAR for TAAA. in preventing paraplegia?
What is the benefit of MEP s in BEVAR for TAAA in preventing paraplegia? P M Kasprzak Department of Vascular Surgery, Endovascular Surgery University Hospital Regensburg, Germany Disclosures Dr. Kasprzak
Preliminary Data from the Gore EXCLUDER Thoracoabdominal Branch Endoprosthesis Early Feasibility Study
Preliminary Data from the Gore EXCLUDER Thoracoabdominal Branch Endoprosthesis Early Feasibility Study Mark A Farber, MD Professor of Surgery and Radiology Director, UNC Aortic Network University of North
Off-the-Shelf Devices. Mark A Farber, MD FACS Director, Aortic Center Professor of Radiology and Surgery University of North Carolina
Off-the-Shelf Devices Mark A Farber, MD FACS Director, Aortic Center Professor of Radiology and Surgery University of North Carolina Disclosures Cook - Research Support, Consultant, Clinical Trials WL
FEVAR FIFTEEN YEARS OF EFFICIENCY E.DUCASSE MD PHD FEBVS CHU DE BORDEAUX
FEVAR FIFTEEN YEARS OF EFFICIENCY E.DUCASSE MD PHD FEBVS CHU DE BORDEAUX 2018 A BIT OF HISTORY First use of F-EVAR : 1990s Park et al. J Vasc Interv Radiol. 1996;7:819-823. Faruqi et al. J Endovasc Surg.
for Thoracoabdominal Aneurysms
Durability of F/BEVAR for Thoracoabdominal Aneurysms Athanasios Katsargyris, MD, Eric Verhoeven MD, PhD Department of Vascular and Endovascular Surgery Paracelsus Medical University, Nuremberg, Germany
Endovascular Treatment of the Aorta with Fenestrated and Branched Grafts
Endovascular Treatment of the Aorta with Fenestrated and Branched Grafts Eric LG Verhoeven,MD, PhD, A. Katsargyris, MD Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany
Jean M Panneton, MD Professor of Surgery Program Director Vascular Surgery Chief EVMS. Arch Pathology: The Endovascular Era is here
Jean M Panneton, MD Professor of Surgery Program Director Vascular Surgery Chief EVMS Arch Pathology: The Endovascular Era is here Disclosures Consultant: Cook Medical, Bolton Medical, Medtronic Inc, Volcano,
Reinhard Kopp, Karin Pfister, Beatrix Cucuruz, Konstantinos Gallis, Piotr M Kasprzak
Immediate, delayed and late spinal cord ischemia after extended endovascular thoracoabdominal aortic repair Reinhard Kopp, Karin Pfister, Beatrix Cucuruz, Konstantinos Gallis, Piotr M Kasprzak Disclosure
Kopp R, Puippe G, Rancic Z, Hofmann M, Pecoraro F, Pfammatter T, Lachat M.. University Hospital Zurich, Switzerland
Low risk of spinal cord ischemia after endovascular repair for suprarenal and thoracoabdominal aortic aneurysms using parallel stent graft implantation. Kopp R, Puippe G, Rancic Z, Hofmann M, Pecoraro
Outcome of the target vessels in endovascular TAAA repair Case #1
Outcome of the target vessels in endovascular TAAA repair Case #1 Nuno Dias Paris Endovascular Aortic Course Paris, 2018-05-31 7.5 cm Type IV TAAA T-branch 1 month Postoperative CT 2.5 months Postoperatively
Conflicts of Interest. Endovascular Repair of Thoracoabdominal Aneurysm. Overview PLANNING ANATOMIC CONSIDERATIONS FOR COMPLEX AORTIC REPAIR
Endovascular Repair of Thoracoabdominal Aneurysm Tim Resch MD Björn Sonesson MD, Nuno Dias MD Vascular Center Skane University Hospital Conflicts of Interest COOK Medical - Consulting, Speakers Bureau,
The Ventana Off-the-Shelf Graft for Pararenal AAA. Andrew Holden Associate Professor of Radiology Auckland Hospital
The Ventana Off-the-Shelf Graft for Pararenal AAA Andrew Holden Associate Professor of Radiology Auckland Hospital Disclosures Andrew Holden, MBChB, FRANZCR Investigator in Nellix and Ventana Trials Clinical
Technique and Outcome of Laser Fenestration For Arch Vessels
Technique and Outcome of Laser Fenestration For Arch Vessels Jean M. Panneton MD, FRCSC, FACS Professor of Surgery Chief & Program Director Division of Vascular Surgery Eastern Virginia Medical School
US clinical trial update on the Gore Excluder iliac branch endoprosthesis (IBE)
US clinical trial update on the Gore Excluder iliac branch endoprosthesis (IBE) Robert Y. Rhee, MD Chief, Vascular and Endovascular Surgery Director, Maimonides Aortic Center Maimonides Medical Center
THORACOABDOMINAL AORTIC ANEURYSMS HYBRID REPAIR
Update on Open and Endovascular Therapeutic Option for Aortic Repair CENTRE CARDIO-TORACIQUE DE MONACO Friday November 7 th, 2014 THORACOABDOMINAL AORTIC ANEURYSMS HYBRID REPAIR Roberto Chiesa Vascular
Associate Professor Walter W. Buckley Endowed Chair in Research Cleveland Clinic Lerner College of Medicine-CWRU. Houston Aortic Symposium 2017
Matthew J. Eagleton, MD Associate Professor Walter W. Buckley Endowed Chair in Research Cleveland Clinic Lerner College of Medicine-CWRU Houston Aortic Symposium 2017 Aortica: Advisory Board Centerline
Nellix Endovascular System: Clinical Outcomes and Device Overview
Nellix Endovascular System: Clinical Outcomes and Device Overview Jeffrey P. Carpenter, MD Professor and Chief, Department of Surgery CAUTION: Investigational device. This product is under clinical investigation
RETROGRADE BRANCH. Gustavo S. Oderich MD Professor of Surgery Director of Endovascular Therapy Division of Vascular and Endovascular Surgery
RETROGRADE BRANCH Gustavo S. Oderich MD Professor of Surgery Director of Endovascular Therapy Division of Vascular and Endovascular Surgery FACULTY DISCLOSURE Consulting* Cook Medical Inc., WL Gore Research
Conflicts of Interest. When and Why Complex EVAR in Tx of juxta/suprarenal AAA? Summary. Infrarenal EVAR for short necks 2y postop
When and Why Complex EVAR in Tx of juxta/suprarenal AAA? Tim Resch MD Vascular Center Skane University Hospital Conflicts of Interest COOK Medical - Consulting, Speakers Bureau, IP, Research support Medtronic
Clinical trial and real-world outcomes of an endovascular iliac aneurysm repair with the GORE Iliac Branch Endoprosthesis (IBE)
Clinical trial and real-world outcomes of an endovascular iliac aneurysm repair with the GORE Iliac Branch Endoprosthesis (IBE) Jan MM Heyligers, PhD, FEBVS Consultant Vascular Surgeon The Netherlands
Challenges. 1. Sizing. 2. Proximal landing zone 3. Distal landing zone 4. Access vessels 5. Spinal cord ischemia 6. Endoleak
Disclosure I have the following potential conflicts of interest to report: Consulting: Medtronic, Gore Employment in industry Stockholder of a healthcare company Owner of a healthcare company Other(s)
Residual Dissection and False Lumen Aneurysm After TEVAR
WHAT WOULD YOU DO? Residual Dissection and False Lumen Aneurysm After MODERATOR: MARK FARBER, MD PANEL: YAZAN DUWAYRI, MD; MATTHEW J. EAGLETON, MD; WILLIAM D. JORDAN Jr, MD; TILO KÖLBEL, MD, PhD; AND ERIC
Bilateral use of the Gore IBE device for bilateral CIA aneurysms and a first interim analysis of the prospective Iceberg registry
Bilateral use of the Gore IBE device for bilateral CIA aneurysms and a first interim analysis of the prospective Iceberg registry Michel MPJ Reijnen, MD, PhD Department of Vascular Surgery, Rijnstate Hospital
Title. Different arch branched devices are available, is morphology the. main criteria of choice? Ciro Ferrer, MD
Different arch branched devices are available, is morphology the Title main criteria of choice? Ciro Ferrer, MD Vascular Surgery Unit Sapienza University of Rome Disclosure Speaker name: Ciro Ferrer Proctoring/speaking
Treatment of Thoracoabdominal Aneurysms Is there a need for custom-made devices?
: FETURED TECHNOLOGY: JOTEC E-XTR DESIGN ENGINEERING Treatment of Thoracoabdominal neurysms Is there a need for custom-made devices? INTERVIEW ND CSE PRESENTTIONS WITH DNIEL RNZN, MD, ND NDREJ SCHMIDT,
Abdominal and thoracic aneurysm repair
Abdominal and thoracic aneurysm repair William A. Gray MD Director, Endovascular Intervention Cardiovascular Research Foundation Columbia University Medical Center Abdominal Aortic Aneurysm Endografts
Percutaneous Axillary Artery Access For Branch Grafting for complex TAAAs and pararenal AAAs: How to do it safely
Percutaneous Axillary Artery Access For Branch Grafting for complex TAAAs and pararenal AAAs: How to do it safely Daniela Branzan, MD, Department of Vascular Surgery University Hospital Leipzig Disclosure
DISCLOSURES ISOLATED DTA LESION? TYPE B DISSECTIONS TREATMENT OPTIONS
Endovascular Repair of Aortic Arch Pathologies; What is available/possible in the U.S. in 2018? Kaiser Permanente Endovascular Symposium 6/2/18 Sukgu M Han, MD, MS Assistant Professor of Clinical Surgery
Redo treatment and open conversion after TEVAR
Redo treatment and open conversion after TEVAR Roberto Chiesa Vascular Surgery, Vita-Salute University Scientific Institute San Raffaele Milan, Italy Number of procedures Off-Label indications for TEVAR
Lessons learned from Ch-EVAR for the treatment of. Miltos Matsagkas MD, PhD, FEBVS Professor of Vascular Surgery University of Thessaly
Lessons learned from Ch-EVAR for the treatment of pararenal AAAs Miltos Matsagkas MD, PhD, FEBVS Professor of Vascular Surgery University of Thessaly Ch-EVAR Ch-EVAR = Chimney-EVAR Placement of single
UC SF. Disclosures. Thoracic Endovascular Aortic Repair 4/24/2009. Management of Acute Dissections: Is There Still a Role for Open Surgery?
UC SF Management of Acute Dissections: Is There Still a Role for Open Surgery? Darren B. Schneider, M.D. Assistant Professor of Surgery and Radiology Division of Vascular Surgery University of California
Accessi Iliaci Ostili
Alma Mater Studiorum Bologna University S.Orsola-Malpighi, Bologna, Italy Vascular Surgery Accessi Iliaci Ostili nel trattamento della patologia aortica E. Gallitto Iliac Navigations Alma Mater Studiorum
Anatomical applicability of current off-the-shelf branched endografts in thoracoabdominal aortic aneurysms managed by open surgery.
Leipzig Interventional Course Update on clinical trials Tuesday, January 30 th, 2018 Anatomical applicability of current off-the-shelf branched endografts in thoracoabdominal aortic aneurysms managed by
Disclosures. EVAR follow-up: actual recommendation. EVAR follow-up: critical issues
Disclosures is it time to discuss individualized follow-up schemes based on preoperative anatomy and high quality completion angiography? Consultant / Speaker / Proctor Cook Cordis Medtronic Invatec W.L.
Re-interventions after TEVAR:
Re-interventions after TEVAR: How often does it occur and what are procedures most commonly utilized to treat these issues? Pacific Northwest Endovascular Conference Seattle, WA June 15, 2018 PENN Surgery
Animesh Rathore, MD, RPVI Sentara Vascular Specialists. Debate 4: Complex endovascular aortic repair will make open surgery obsolete
Animesh Rathore, MD, RPVI Sentara Vascular Specialists Debate 4: Complex endovascular aortic repair will make open surgery obsolete Definition Complex aortic pathology (aneurysms/dissection) Involvement
I-Hui Wu, M.D. Ph.D. Clinical Assistant Professor Cardiovascular Surgical Department National Taiwan University Hospital
Comparisons of Aortic Remodeling and Outcomes after Endovascular Repair of Acute and Chronic Complicated Type B Aortic Dissections I-Hui Wu, M.D. Ph.D. Clinical Assistant Professor Cardiovascular Surgical
Expert Discussion: When to Preserve the Hypogastric Artery
Pr e s er ving the Hyp ogas tric A r ter y Expert Discussion: When to Preserve the Hypogastric Artery WITH PROF. ANTOINE MILLON, MD, P hd; ROSS MILNER, MD, FACS; GUSTAVO S. ODERICH, MD; DARREN B. SCHNEIDER,
Low profile TEVAR: is it an added value? Michel Bosiers, G. Torsello Münster
Low profile TEVAR: is it an added value? Michel Bosiers, G. Torsello Münster Disclosure Speaker name:...michel Bosiers... I have the following potential conflicts of interest to report: Consulting Employment
DIFFICULT ACCESS REMAINS A CONTRAINDICATION FOR EVAR APOSTOLOS K. TASSIOPOULOS, MD, FACS PROFESSOR AND CHIEF DIVISION OF VASCULAR SURGERY
DIFFICULT ACCESS REMAINS A CONTRAINDICATION FOR EVAR APOSTOLOS K. TASSIOPOULOS, MD, FACS PROFESSOR AND CHIEF DIVISION OF VASCULAR SURGERY Disclosures Speaker Bureau: - Medtronic - Cook Medical - Bolton
Stent graft modification with mini-cuff reinforced fenestrations for urgent repair of thoracoabdominal aortic aneurysms
VASCULAR AND ENDOVASCULAR TECHNIQUES Thomas L. Forbes, MD, Section Editor Stent graft modification with mini-cuff reinforced fenestrations for urgent repair of thoracoabdominal aortic aneurysms Gustavo
Antegrade Thoracic Stent Grafting during Repair of Acute Debakey I Dissection: Promotes Distal Aortic Remodeling and Reduces Late Open Re-operation
Antegrade Thoracic Stent Grafting during Repair of Acute Debakey I Dissection: Promotes Distal Aortic Remodeling and Reduces Late Open Re-operation Vallabhajosyula, P: Szeto, W; Desai, N; Pulsipher, A;
Combined Endovascular and Surgical Repair of Thoracoabdominal Aortic Pathology: Hybrid TEVAR
Combined Endovascular and Surgical Repair of Thoracoabdominal Aortic Pathology: Hybrid TEVAR William J. Quinones-Baldrich MD Professor of Surgery Director UCLA Aortic Center UCLA Medical Center Los Angeles,
My personal experience with INCRAFT in standard and challenging cases
My personal experience with INCRAFT in standard and challenging cases G Pratesi, MD Vascular Surgery University of Rome Tor Vergata giovanni.pratesi@uniroma2.it Disclosure Speaker name: Giovanni Pratesi,
Alma Mater Studiorum Bologna University. S.Orsola-Malpighi, Bologna, Italy Vascular Surgery
Alma Mater Studiorum Bologna University S.Orsola-Malpighi, Bologna, Italy Vascular Surgery L orientamento dell arteria renale influenza gli outcomes renali nel trattamento endovascolare degli aneurismi
Experience of endovascular procedures on abdominal and thoracic aorta in CA region
Experience of endovascular procedures on abdominal and thoracic aorta in CA region May 14-15, 2015, Dubai Dr. Viktor Zemlyanskiy National Research Center of Emergency Care Astana, Kazakhstan Region Characteristics
Endovascular therapy for Ischemic versus Nonischemic complicated acute type B aortic dissection (catbad).
Endovascular therapy for Ischemic versus Nonischemic complicated acute type B aortic dissection (catbad). AS. Eleshra, MD 1, T. Kölbel, MD, PhD 1, F. Rohlffs, MD 1, N. Tsilimparis, MD, PhD 1,2 Ahmed Eleshra
Current strategies to prevent spinal cord ischemia in TAAA repair
Current strategies to prevent spinal cord ischemia in TAAA repair Geert Willem Schurink Barend Mees Noud Peppelenbosch Michiel de Haan Michael Jacobs Maastricht University Medical Center, the Netherlands
INCRAFT system: Update from the Pivotal INSPIRATION Study
INCRAFT system: Update from the Pivotal INSPIRATION Study Michel S. Makaroun MD Co-Director, UPMC Heart and Vascular Institute Professor and Chair, Division of Vascular Surgery University of Pittsburgh
Neurological Complications of TEVAR. Frank J Criado, MD. Union Memorial-MedStar Health Baltimore, MD USA
ISES Online Neurological Complications of Frank J Criado, MD TEVAR Union Memorial-MedStar Health Baltimore, MD USA frank.criado@medstar.net Paraplegia Incidence is 0-4% after surgical Rx of TAAs confined
Endovascular Repair of Aortic Arch/Thoracic Aneurysms: Bolton RelayBranch Device
Endovascular Repair of Aortic Arch/Thoracic Aneurysms: Bolton RelayBranch Device Luis A. Sanchez MD Gregorio A. Sicard Distinguished Professor of Surgery & Radiology Chief, Section of Vascular Surgery
The Role of Debranching in Endovascular Repair
The Role of Debranching in Endovascular Repair of TAAAs Hybrid repair is an alternative in patients who are not candidates for open surgery or total endovascular approaches. By Gustavo S. Oderich, MD Hybrid
Development of a Branched LSA Endograft & Ascending Aorta Endograft
Development of a Branched LSA Endograft & Ascending Aorta Endograft Frank R. Arko III, MD Sanger Heart & Vascular Institute Carolinas Medical Center Charlotte, North Carolina, USA Disclosures Proximal
Hybrid Repair of a Complex Thoracoabdominal Aortic Aneurysm
Hybrid Repair of a Complex Thoracoabdominal Aortic Aneurysm Virendra I. Patel MD MPH Assistant Professor of Surgery Massachusetts General Hospital Division of Vascular and Endovascular Surgery Disclosure
Exceptions to the Rules: Abdominal and Thoracic Aneurysms
Exceptions to the Rules: Abdominal and Thoracic Aneurysms Jason Bayne MD, FRCSC Vascular Surgery Jewish General Hospital Assistant Professor, Program Director McGill University Objectives Risk factors
Development of Stent Graft. Kato et al. Development of an expandable intra-aortic prothesis for experimental aortic dissection.
Development of Stent Graft Kato et al. Development of an expandable intra-aortic prothesis for experimental aortic dissection. ASAIO J 1993 The New England Journal of Medicine Downloaded from nejm.org
Current State of Thoracic Branch Devices and Ongoing Clinical Trials
Current State of Thoracic Branch Devices and Ongoing Clinical Trials Hiroo Takayama, MD, PhD Associate Professor of Surgery Director of Cardiovascular Institute Co-Director of Aortic Center NY Presbyterian/Columbia
Durable outcomes. Proven performance.
Durable outcomes. Proven performance. GORE EXCLUDER AAA Endoprosthesis GORE EXCLUDER Iliac Branch Endoprosthesis GORE EXCLUDER AAA Endoprosthesis The most-studied* EVAR stent graft designed for durable
Ovation. Sean Lyden, MD Department Chair, Vascular Surgery Cleveland Clinic
Ovation Sean Lyden, MD Department Chair, Vascular Surgery Cleveland Clinic Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when?
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when? Prof. Olgierd Rowiński II Department of Clinical Radiology Medical University of Warsaw Disclosure Speaker name: Olgierd
Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience
Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience Joost van Herwaarden, MD, PhD University Medical Center, Utrecht Disclosure I have the following potential
Is there a way to predict the risk in uncomplicated Type B aortic dissections? FRANS MOLL University Medical Centre Utrecht - Netherlands
Is there a way to predict the risk in uncomplicated Type B aortic dissections? FRANS MOLL University Medical Centre Utrecht - Netherlands Disclosures: - Consultant Philips Health Care - Best Doctors Overview
The Petticoat Technique Managing Type B Dissection with both Early and Long Term Considerations
The Petticoat Technique Managing Type B Dissection with both Early and Long Term Considerations Joseph V. Lombardi, MD Professor & Chief, Division of Vascular & Endovascular Surgery Department of Surgery,
EndoVascular Aneurysm Sealing (EVAS) with Nellix
1 2 EndoVascular Aneurysm Sealing (EVAS) with Nellix Designed to seal entire aneurysm with contained biostable polymer Non-modular design with complete fixation Expands endovascular patient eligibility
Treatment options of late failures of EVAS. Michel Reijnen Rijnstate Arnhem The Netherlands
Treatment options of late failures of EVAS Michel Reijnen Rijnstate Arnhem The Netherlands Disclosure Speaker name: Michel Reijnen I have the following potential conflicts of interest to report: Consulting
Aortic Arch pathology options: Open,Hybrid, fenestration, Chimney or branched stent-graft?
Aortic Arch pathology options: Open,Hybrid, fenestration, Chimney or branched stent-graft? Chang Shu, M.D., Ph.D Vascular Surgery Center National Center for Cardiovascular Diseases. Fuwai Hospital, CAMS
Predictors of abdominal aortic aneurysm sac enlargement after EVAR Longterm results from the ENGAGE Registry
Predictors of abdominal aortic aneurysm sac enlargement after EVAR Longterm results from the ENGAGE Registry D. Böckler Department of Vascular and Endovascular Surgery University Hospital Heidelberg Disclosure
Complex Thoracic and Abdominal Aortic Repair Using Hybrid Techniques
Complex Thoracic and Abdominal Aortic Repair Using Hybrid Techniques Tariq Almerey MD, January Moore BA, Houssam Farres MD, Richard Agnew MD, W. Andrew Oldenburg MD, Albert Hakaim MD Department of Vascular
Aortic Arch Treatment Open versus Endo Evidence versus Zeitgeist. M. Grabenwoger Dept. of Cardiovascular Surgery Hospital Hietzing Vienna, Austria
Aortic Arch Treatment Open versus Endo Evidence versus Zeitgeist M. Grabenwoger Dept. of Cardiovascular Surgery Hospital Hietzing Vienna, Austria Evidence Surgical aortic arch replacement with a Dacron
Three year experience with multilayer stent in the treatment of thoracoabdominal aneurysms no evidence for aneurysm stabilization
Three year experience with multilayer stent in the treatment of thoracoabdominal aneurysms no evidence for aneurysm stabilization Thomas Larzon, MD, PhD Head of Vascular Surgery Dept of Cardiothoracic
Reinterventions After Fenestrated and Branched Endovascular Aortic Aneurysm Repair
Reinterventions After Fenestrated and Branched Endovascular Aortic Aneurysm Repair Andres Schanzer, MD Division of Vascular and Endovascular Surgery UMass Medical School June 15 th, 2018 PNEC, Seattle,
Paraplegia in endovascular repair of TAA and in TEVAR: Incidence, prevention and therapy. Johannes Lammer Medical University Vienna, Austria
Paraplegia in endovascular repair of TAA and in TEVAR: Incidence, prevention and therapy Johannes Lammer Medical University Vienna, Austria Conflict of interests: none 68y, male, PAU in coral reef aorta,
What does the data tell us about outcomes of EVAR in challenging anatomy?
What does the data tell us about outcomes of EVAR in challenging anatomy? UCSF Vascular Surgery Symposium 2018 Sukgu M Han, MD, MS Assistant Professor of Clinical Surgery Co-director, Comprehensive Aortic
A New EVAR Device for Infrarenal AAAs
A New EVAR Device for Infrarenal AAAs Peter Nelson, MD, MS Assistant Professor of Surgery MM0203 Rev. 01 Current U.S. EVAR Devices Anatomical Fixation Proximal Fixation Powerlink - Endologix Excluder WL
Percutaneous Approaches to Aortic Disease in 2018
Percutaneous Approaches to Aortic Disease in 2018 Wendy Tsang, MD, SM Assistant Professor, University of Toronto Toronto General Hospital, University Health Network Case 78 year old F Lower CP and upper
EVAR and TEVAR: Extending Their Use for Rupture and Traumatic Injury. Conflict of Interest. Hypotensive shock 5/5/2014. none
EVAR and TEVAR: Extending Their Use for Rupture and Traumatic Injury Bruce H. Gray, DO MSVM FSCAI Professor of Surgery/Vascular Medicine USC SOM-Greenville Greenville, South Carolina none Conflict of Interest
How effective is preservation when viewed through a clinical and economic lens?
How effective is preservation when viewed through a clinical and economic lens? Nilo J Mosquera, MD. Head of Department Angiology and Vascular Surgery Department. Complexo Hospitalario Universitario de
Insights from the PROTAGORAS/PERICLES Registries: impact on ChEVAR results
Insights from the PROTAGORAS/PERICLES Registries: impact on ChEVAR results Konstantinos P. Donas, Giovanni Torsello Department of Vascular Surgery St. Franziskus Hospital Münster, Germany Disclosure Speaker
Optimizing Accuracy of Aortic Stent Grafts in Short Necks
Optimizing Accuracy of Aortic Stent Grafts in Short Necks Venkatesh Ramaiah, MD, FACS Medical Director Arizona Heart Hospital Director Peripheral Vascular and Endovascular Research Arizona Heart Institute
Taming The Aorta. David Minion, MD Program Director, Vascular Surgery University of Kentucky Medical Center Lexington, Kentucky, USA
Taming The Aorta David Minion, MD Program Director, Vascular Surgery University of Kentucky Medical Center Lexington, Kentucky, USA Faculty Disclosure Consulting: Endologix, Cook 1 Objectives Review the
Retrograde Embolization of a Symptomatic Hypogastric Artery Aneurysm
Retrograde Embolization of a Symptomatic Hypogastric Artery Aneurysm Andrew Unzeitig MD Piedmont Atlanta Hospital Georgia Vascular Society 2017 Annual Meeting Lake Oconee, Georgia Disclosures None Case
Tips and Tricks to Deliver a Stengraft to the Ascending Aorta
Tips and Tricks to Deliver a Stengraft to the Ascending Aorta Tilo Kölbel, MD, PhD University Heart Center University Hospital Eppendorf Hamburg, Germany Disclosures Research-grants, travelling, proctoring
Clinical Outcomes Among Vascular Procedure Patients Receiving Suture-mediated vs Surgical Cutdown for Closure of Large-bore Arterial Access
Clinical Outcomes Among Vascular Procedure Patients Receiving Suture-mediated vs Surgical for Closure of Large-bore Arterial Access Ramon L. Varcoe, MBBS, MS, FRACS, PhD Associate Professor of Vascular
EVAR replaced standard repair in most cases. Why?
EVAR replaced standard repair in most cases. Why? Initial major steps in endograft evolution Papazoglou O. Konstantinos M.D. The story of a major breakthrough in vascular surgery 1991 Parodi introduces
Durability of The Endurant Stent-Graft through 5 Years
Durability of The Endurant Stent-Graft through 5 Years Michel S. Makaroun MD Co-Director, UPMC Heart and Vascular Institute Professor and Chair, Division of Vascular Surgery University of Pittsburgh School
Anatomical challenges in EVAR
Anatomical challenges in EVAR M.H. EL DESSOKI, MD,FRCS PROFESSOR OF VASCULAR SURGERY CAIRO UNIVERSITY Disclosure Speaker name:... I have the following potential conflicts of interest to report: Consulting
Percutaneous access and closure of the axillary artery during complex aortic endovascular procedures
Percutaneous access and closure of the axillary artery during complex aortic endovascular procedures Luca Bertoglio, Andrea Melloni, Maria Katsarou, Alessandra Fittipaldi, Simone Salvati, Andrea Kahlberg,
Daniela Branzan MD, Department of Vascular Surgery and Department of Interventional Angiology University Hospital Leipzig
Ischemic Preconditioning with Minimally Invasive Segmental Artery Coil Embolization (MISACE) prior to Endovascular TAAA Repair: Clinical Experience in 50+ Patients Daniela Branzan MD, Department of Vascular
Advances in Treatment of Traumatic Aortic Transection
Advances in Treatment of Traumatic Aortic Transection Himanshu J. Patel MD University of Michigan Medical Center Author Disclosures Consulting fees from WL Gore Inc. There is no disease more conducive
Challenges with Complex Anatomies Advancing Care in Endovascular Aortic Treatment
Challenges with Complex Anatomies Advancing Care in Endovascular Aortic Treatment Robert Y. Rhee, MD Chief, Vascular and Endovascular Surgery Director, Aortic Center Maimonides Medical Center Brooklyn,
11/20/2014. Disclosures. Kissing Balloons and Stents. Treatment of Aortoiliac Occlusive Disease. Data on Patency of Kissing Stents.
RESULTS FROM A MULTI-CENTER, RETROSPECTIVE REVIEW OF THE AFX ENDOGRAFT FOR USE IN AORTOILIAC OCCLUSIVE DISEASE Disclosures Cook Endologix Medtronic Thomas Maldonado, MD Associate Professor Department of
Performance of the conformable GORE TAG device in Type B aortic dissection from the GORE GREAT real world registry
University of Milan Thoracic Aortic Research Center Performance of the conformable GORE TAG device in Type B aortic dissection from the GORE GREAT real world registry Santi Trimarchi, MD, PhD Associate
Objective assessment of current stent grafts: which graft for which lesion. Ludovic Canaud, MD, PhD Pierre Alric, MD, PhD Montpellier, France
Objective assessment of current stent grafts: which graft for which lesion Ludovic Canaud, MD, PhD Pierre Alric, MD, PhD Montpellier, France Conflict of interest: none 1 Introduction Different diseases
ChEVAR Vs. fevar for juxtarenal Aneurysm. E.Ducasse MD PhD FEVBS Unit of vascular surgery CHU bordeaux
ChEVAR Vs. fevar for juxtarenal Aneurysm E.Ducasse MD PhD FEVBS Unit of vascular surgery CHU bordeaux CH-EVAR VS. F-EVAR IN JAAAs Meta-analysis, 2001-2012 5 CH-EVAR studies (94 patients, 151 target vessels)
WHAT IS THE BEST OPTION FOR ARCH ANEURYSMS?
WHAT IS THE BEST OPTION FOR ARCH ANEURYSMS? Prof. Furuzan Numan M.D Chief of Interventional Radiology Department Cerrahpasa Medical Faculty & Memorial Hospital, ISTANBUL, TURKIYE 3ad INTERNATIONAL MEETING
ENCORE, a Study to Investigate the Durability of Polymer EVAR with Ovation A Contemporary Review of 1296 Patients
ENCORE, a Study to Investigate the Durability of Polymer EVAR with Ovation A Contemporary Review of 1296 Patients The Ovation System is approved to treat infrarenal abdominal aortic aneurysms and is not
Endoanchor-assisted TEVAR
Endoanchor-assisted TEVAR May 29, 2015 NCVH2015 Grayson H. Wheatley III, MD Director of Aortic and Endovascular Surgery Associate Professor of Surgery Temple University School of Medicine Disclosures Consultant