New technologies: branched, fenestrated and chimney devices


New technologies were discussed at the VEITHsymposium, in New York, in November 2008.

New branched device (Medtronic)

According to Dr Furuzan Numan, this novel endovascular arch reconstruction technique may become an alternative way of therapy for patients with aortic arch pathologies by using off the shelf products, to deliver patient-tailored solutions.


Preloaded fenestrated graft system (Cook)

Dr Krassi Ivancev discussed initial results of a study Cook’s preloaded fenestrated graft system. Ivancev stated that so far eight patients worldwide have been treated with the device for pararenal AAA. He found that the system offers quicker and safer catheterisations of the target vessels, i.e., renal arteries, compared to the currently existing system. The new system also anticipated to be used for other target vessels such as the superior mesenteric artery and the celiac trunk. The system can also be used with advantage on patients in whom catheterisation from the contra lateral side is impossible or severely impeded, said Ivancev.


New VORTEC (using the GORE Viabahn) and Chimney procedures

In a study by Dr Mario Lachat, 118 arteries (renal artery, n=103; superior mensenteric artery, n=9; and celiac trune, n=6) were successfully revascularised using VORTEC (Viabahn open rebranching technique). The technical success rate was 100% with all the stent grafts implanted as intended with maintenance of flow. The patency rates were 97% after 30 days, and 95% after a mean follow-up of 18 months. Lachat and colleagues concluded that VORTEC allows performance of safe and expeditious revascularisation of visceral arteries. The technique allows reducing duration of flow interruption and simplifying the performance of complex aortic branches reconstructions.
The Chimney procedure can be used for all aortic branches, said Dr Martin Malina. He added that it offers an alternative to branched stentgrafts, however, dedicated composite Chimney grafts are needed.