Presentation

Percutaneous thrombectomy of bridging stent-grafts after chEVAR

This case demonstrates the percutaneous transluminal thrombectomy of a bridging stent-graft after chEVAR. The clot removal was performed with the Indigo thrombectomy catheter (Penumbra) through a transaxillary approach. In this video, you will find important technical aspects as well as all relevant characteristics of the device.

Comments

    June 2, 2018

    Hi Arne, very nice !!! Why did it occlude? There seems to be quite an oversize between the native renal and the chimney stent graft

    Dr. Theodosios Bisdas
    June 2, 2018

    Hi Philippe! You mean probably Theo! 🙂 We have seen several occlusions with the bridging stent-grafts after both chimney and branched endografting and the majority of them were observed at the renal arteries. The incidence is lower with fenestrated endografts. The oversizing was 1 mm as usually. We think that the problem was the relining with the bare-metal stent. In the video (7:31), after the Indigo thrombectomy, someone has the feeling that the distal end of the bare metal stent has almost perforated the native vessel wall.
    We have studied this issue in a previous paper (Panuccio et al. Eur J Vasc Endovasc Surg. 2015 Jul;50(1):60-70) and we found that relining of the Advanta with a self-expanded bare-metal stent was a risk factor for occlusion in the renal arteries after brEVAR.

    June 3, 2018

    Hi Theo, sorry I answered initially to the post of Arne on LinkedIn..

    Very interesting to know that relining an Advanta is rather not so Good. The video is very helpful to learn how to do it!!! Thank you very much! Points taken!

    Best from Baden, Phil

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