title: Push-Up Technique and Anatomical Deployment With the Endurant Stent-Graft System for Severely Angulated Aneurysm Necks.
abstract: To describe a technique suitable for treating severely angulated (>75°) necks during endovascular aneurysm repair using the Endurant stent-graft.
  
  
  
  In the push-up technique, the suprarenal stent is released early to fix the proximal stent-graft in place so that each stent in the neck can be deployed individually without displacing the device upward. It is important to push the delivery system up after each stent deployment to allow the fabric between the stents to fold up circumferentially. By doing so, there is minimal upward force applied to the suprarenal stent. Because the stents expand along the angulated neck while catching blood flow, this anatomical deployment is feasible, with hardly any change to the proximal neck shape after stent-graft implantation.
  
  
  
  The push-up technique and anatomical deployment with the Endurant stent-graft system are effective and safe methods for treating aneurysms with severely angulated necks.
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Shizuyuki
authors.initials: S
authors.lastname: Dohi
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Taira
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuwaki
authors.affiliation: 2 Department of Cardiovascular Surgery, Kobari General Hospital, Chiba, Japan.
authors.forename: Akifusa
authors.initials: A
authors.lastname: Hariya
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Kan
authors.initials: K
authors.lastname: Kajimoto
authors.affiliation: 3 Department of Cardiovascular Surgery, Edogawa Hospital, Tokyo, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Yamaoka
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Akie
authors.initials: A
authors.lastname: Shimada
authors.affiliation: 4 Department of Cardiovascular Surgery, Kamagaya General Hospital, Chiba, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Tsuruta
authors.affiliation: 1 Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: abdominal aortic aneurysm; angulation; aortic neck; deployment technique; endograft; stent-graft