Endovascular aneurysm sealing addresses several limitations of conventional endovascular aneurysm repair.
Endovascular aneurysm repair has enabled a broad population of patients with infrarenal abdominal aortic aneurysm to be treated by a less-invasive technique. However, endovascular aneurysm repair has therapeutic limitations, including the need for lifelong surveillance and a higher rate of secondary interventions than open repair. These outcomes can promote patient dissatisfaction and result in increased health care costs and associated morbidity and mortality. The primary reason for secondary interventions is continued abdominal aortic aneurysm sac enlargement due to endoleaks. Conventional endovascular aneurysm repair procedures do not address aortic branch vessels that are ligated during open repairs. Secondary measures to occlude these branch vessels have shown efficacy in limiting sac growth, but do not predictably eliminate the need for further interventions. Endovascular aneurysm sealing is a new technique that addresses some of the limitations of conventional endovascular repair. Endovascular aneurysm sealing secures the stent graft flow lumens within a biostable polymer. This stability prevents stent migration while also sealing branch vessels that are otherwise not addressed by other endovascular devices. This new approach to endovascular repair has shown early promise in reducing the rates of endoleak and need for secondary interventions, while opening up the possibility of durable endovascular repair to a more challenging type of anatomy.
Department of Vascular Surgery, MedStar Health, 110 Irving Street NW, Washington, DC 20010. Electronic address: zachary.w.kostun@medstar.net.
Zachary W
ZW
Kostun
Department of Vascular Surgery, MedStar Health, 110 Irving Street NW, Washington, DC 20010.
Edward Y
EY
Woo
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods*; D057867:Endoleak / Q000209:etiology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D011474:Prosthesis Design; D012086:Reoperation