Rhee Robert, Peterson Brian, Moore Erin, Lepore Michael, Oderich Gustavo
Department of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY.
Department of Vascular Surgery, St. Anthony's Medical Center, St. Louis, Mo.
J Vasc Surg Cases Innov Tech. 2019 Jun 29;5(3):319-322. doi: 10.1016/j.jvscit.2019.03.014. eCollection 2019 Sep.
Endovascular repair has become the standard of care for treatment of abdominal aortic aneurysms. The endografts and delivery systems for endovascular aneurysm repair have undergone multiple generations of technologic advancements. However, a significant remaining challenge for a satisfactory long-term outcome is to improve the performance of these devices in nonideal proximal sealing zones. In particular, short (<15 mm) and highly angulated (>60 degrees) necks can threaten long-term exclusion of the aneurysm even with the current generation of endografts. One of the main reasons for proximal infrarenal neck failure is the inability to accurately position the endograft precisely below both renal arteries. This is a report of the first-in-human implantations of the GORE EXCLUDER Conformable AAA Endoprosthesis (W. L. Gore & Associates, Flagstaff, Ariz), an investigational device, in anatomies with standard neck lengths and angulation. This device has been designed to provide repositionability, conformability, and, for the first time, optional angulation control. This device is commercially available in Europe.
血管内修复已成为治疗腹主动脉瘤的标准治疗方法。用于血管内动脉瘤修复的血管内移植物和输送系统已经历了多代技术进步。然而，要获得令人满意的长期疗效，一个重大的挑战仍然是提高这些装置在非理想近端密封区的性能。特别是，短（<15毫米）且高度成角（>60度）的颈部即使使用当前一代血管内移植物也可能威胁到动脉瘤的长期隔绝。近端肾下颈部失败的主要原因之一是无法将血管内移植物精确地放置在双侧肾动脉下方。本文报告了研究性器械GORE EXCLUDER顺应性AAA血管内假体（美国亚利桑那州弗拉格斯塔夫市的W. L. 戈尔公司）在具有标准颈部长度和成角的解剖结构中的首例人体植入情况。该装置旨在提供可重新定位性、顺应性，并且首次实现了可选的角度控制。该装置在欧洲已上市。
