Emergent endovascular treatment options for thoracoabdominal aortic aneurysm
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Emergent endovascular treatment options for thoracoabdominal aortic aneurysm. / Grandi, Alessandro; Melloni, Andrea; D'Oria, Mario; Lepidi, Sandro; Bonardelli, Stefano; Kölbel, Tilo; Bertoglio, Luca.
in: SEMIN VASC SURG, Jahrgang 36, Nr. 2, 06.2023, S. 174-188.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Emergent endovascular treatment options for thoracoabdominal aortic aneurysm
AU - Grandi, Alessandro
AU - Melloni, Andrea
AU - D'Oria, Mario
AU - Lepidi, Sandro
AU - Bonardelli, Stefano
AU - Kölbel, Tilo
AU - Bertoglio, Luca
N1 - Copyright © 2023 Elsevier Inc. All rights reserved.
PY - 2023/6
Y1 - 2023/6
N2 - For a long time, parallel grafting, physician-modified endografts, and, more recently, in situ fenestration were the only go-to endovascular options for ruptured thoracoabdominal aortic aneurysm, offered mixed results, and depended mainly on the operator's and center's experience. As custom-made devices have become an established endovascular treatment option for elective thoracoabdominal aortic aneurysm, they are not a viable option in the emergency setting, as endograft production can take up to 4 months. The development of off-the-shelf (OTS) multibranched devices with a standardized configuration has allowed the treatment of ruptured thoracoabdominal aortic aneurysm with emergent branched endovascular procedures. The Zenith t-Branch device (Cook Medical) was the first readily available graft outside the United States to receive the CE mark (in 2012) and is currently the most studied device for those indications. A new device, the E-nside thoracoabdominal branch endoprosthesis OTS multibranched endograft (Artivion), has been made commercially available, and the GORE EXCLUDER thoracoabdominal branch endoprosthesis OTS multibranched endograft (W. L. Gore and Associates) is expected to be released in 2023. Due to the lack of guidelines on ruptured thoracoabdominal aortic aneurysm, this review summarizes the available treatment options (ie, parallel grafts, physician-modified endografts, in situ fenestrations, and OTS multibranched devices), compares the indications and contraindications, and points out the evidence gaps that should be filled in the next decade.
AB - For a long time, parallel grafting, physician-modified endografts, and, more recently, in situ fenestration were the only go-to endovascular options for ruptured thoracoabdominal aortic aneurysm, offered mixed results, and depended mainly on the operator's and center's experience. As custom-made devices have become an established endovascular treatment option for elective thoracoabdominal aortic aneurysm, they are not a viable option in the emergency setting, as endograft production can take up to 4 months. The development of off-the-shelf (OTS) multibranched devices with a standardized configuration has allowed the treatment of ruptured thoracoabdominal aortic aneurysm with emergent branched endovascular procedures. The Zenith t-Branch device (Cook Medical) was the first readily available graft outside the United States to receive the CE mark (in 2012) and is currently the most studied device for those indications. A new device, the E-nside thoracoabdominal branch endoprosthesis OTS multibranched endograft (Artivion), has been made commercially available, and the GORE EXCLUDER thoracoabdominal branch endoprosthesis OTS multibranched endograft (W. L. Gore and Associates) is expected to be released in 2023. Due to the lack of guidelines on ruptured thoracoabdominal aortic aneurysm, this review summarizes the available treatment options (ie, parallel grafts, physician-modified endografts, in situ fenestrations, and OTS multibranched devices), compares the indications and contraindications, and points out the evidence gaps that should be filled in the next decade.
KW - Humans
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Aortic Aneurysm, Thoracoabdominal
KW - Aortic Aneurysm, Thoracic/diagnostic imaging
KW - Treatment Outcome
KW - Prosthesis Design
KW - Stents
KW - Endovascular Procedures
KW - Aortic Rupture/diagnostic imaging
KW - Aortic Aneurysm, Abdominal/surgery
U2 - 10.1053/j.semvascsurg.2023.04.004
DO - 10.1053/j.semvascsurg.2023.04.004
M3 - SCORING: Review article
C2 - 37330232
VL - 36
SP - 174
EP - 188
JO - SEMIN VASC SURG
JF - SEMIN VASC SURG
SN - 0895-7967
IS - 2
ER -