title: Experience with a scalloped thoracic stent graft: a good alternative to preserve flow to the celiac and superior mesenteric arteries and to improve distal fixation and sealing.
abstract: Thoracic endografting has been proposed as an effective alternative to open repair to treat several aortic pathologies. Cranial migration is one of the critical issues concerning long-term durability. The scalloped thoracic endograft was proposed to improve distal sealing and fixation crossing the diaphragm. The objective of this study was to evaluate technical feasibility and experience with a custom-made scalloped thoracic endograft using the Relay platform (Bolton Medical, Sunrise, FL) in selected cases. From January 2006 to June 2009, 57 patients (40 men) were treated in Europe with a customized distal scalloped thoracic endograft. Forty-five patients presented with thoracic aortic aneurysm, nine presented with type B dissection, and three had a pseudoaneurysm. Successful and accurate deployment was achieved in all cases except one partial rotation in an extremely tortuous anatomy. Technical success was achieved in 96.4%. Good sealing and no mortality, paraplegia, or visceral embolization were observed. At a mean follow-up of 6 months, no complications were registered. The Relay endograft with the distal scallop represents a feasible alternative for distal short necks. This approach may increase the applicability and durability of the endograft in short distal necks.
authors.affiliation: Thorax Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Marcio
authors.initials: M
authors.lastname: Da Rocha
authors.forename: Vicent A
authors.initials: VA
authors.lastname: Riambau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002445:Celiac Artery / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000503:physiopathology*; D008875:Middle Aged; D011474:Prosthesis Design; D012039:Regional Blood Flow; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome