Post on 22-Nov-2018
Gelweave™Branched Grafts with Radiopaque Markers Suitable for Debranching and Associated Hybrid Procedures
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Branched Grafts with Radiopaque Markers Suitable for Debranching and Associated Hybrid Procedures
• Theuseofsidebranchgraftsisintendedtofacilitatethedeliveryof
endovasculardevicesinhighrisksurgicalpatients1
• Sidebranchgraftsmaybeusedinthetreatmentofthoracicand
thoracoabdominalaneurysms1,2
• Debranchingandhybridproceduresofcomplexthoracicand
thoracoabdominalaneurysmsexpandthefieldofendovascularstentgrafting
inhighrisksurgicalpatients3,5
• Althoughopensurgicalrepairremainsthegoldstandardtreatmentforfit
patients,hybridproceduresincludingdebranchingofthearchvesselsfor
aorticarchpathologyfollowedbycompletionoftheendovascularprocedure
arefeasibleinselectedhighsurgicalriskpatients4
• Theuseofhybridproceduresprovidesanalternativetoopenrepairinhigh
risksurgicalpatientswithcomplexaorticpathology3,4,5
• Patentedradiopaquemarkerdesigns6
• Theradiopaquemarkers
-improvein vivovisualization7
-facilitateprecisestentgraftpositioning8
Overall,theliteratureconcludesthattheseproceduresprovideatherapeutic
alternativetopatientswhowouldbeotherwiseinoperable.1
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DesignedinassociationwithGiampiero Esposito,MD,ChiefofCardiovascularSurgeryDepartment,SantaMariaHospital,Bari,Italy.
Bore Size Length Bore Size Length (mm) (cm) (mm) (cm)
Catalogue No.
Body Branches
20 40 22 40 24 40 26 40 28 40 30 40 32 40 34 40
A B C D 10108101010810101081010108101010810101081010108101010810
734020CX4RMS734022CX4RMS734024CX4RMS734026CX4RMS734028CX4RMS734030CX4RMS734032CX4RMS734034CX4RMS
A B C D 4030303040303030403030304030303040303030403030304030303040303030
Patentedradiopaquemarkerdesign
Brachiocephalictrunkbranch
Leftcommoncarotidarterybranch
Leftsubclavianartery,perfusionsidebranchorendovascularsystemdeliverybranch
Leftsubclavianarteryorbypasstothevisceralarteries
Aorticarchsection
A
B
C
D
30o
Lupiae™ Branched Graft
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Examples of Completed Debranching Hybrid Procedures
Ascendingaorta,arch&descendingaorticaneurysm
Supra-renalthoracoabdominalaorticaneurysminvolvingtheascendingaorta
Radiopaquemarkersimprovein vivovisualization
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Branched Arch Graft with RadiopaqueMarkers
DesignedinassociationwithJoseph E Bavaria, MD,ProfessorofSurgeryandDirectoroftheThoracicAorticSurgeryProgram,UniversityofPennsylvania,Philadelphia,PA.
BoreSizes UsableLengths Catalogue(mm) (cm) No.
A B C D E A B C D E 221012882030151530732022CX4RM241012882030151530 732024CX4RM261012882030151530 732026CX4RM281012882030151530 732028CX4RM301012882030151530 732030CX4RM321012882030151530 732032CX4RM341012882030151530732034CX4RM
A
20o
20o
45o
B
CD
E
Leftsubclavianarterybranch
Leftcommoncarotidarterybranch
Brachiocephalictrunkbranch
Perfusion/endovascularsystemdeliverybranch
Aorticarchsection
Radiopaquemarkersx2
=radiopaquemarker
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Thoracic Arch Graft with Radiopaque Marker
DesignedinassociationwithG. Chad Hughes, MD,AssistantProfessorofSurgery,DirectoroftheThoracicAorticSurgeryProgram,SectionofCardiovascular&ThoracicSurgery,DukeUniversityMedicalCenter,Durham,NC.
BoreSizes UsableLengths Catalogue(mm) (cm) No.A B C A B C 12108 222513 732212/10/8CRM141010 222513 732214/10/10CRM
A
20o
B
C
100o
Joinstoaorticarch
Brachiocephalictrunkbranch
Leftcommoncarotidarterybranch
Perfusion/endovascularsystemdeliverybranch
Radiopaquemarker
=radiopaquemarker
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Thoracoabdominal Graft with Radiopaque Markers
C
45o
45o
B
A
F
45o
45o
D
E
Note:BranchBoffsetat45otosectionA.Radiopaquemarkerunderneathbranch.
Celiacaxis
Oversewn
Superiormesentericartery
Leftrenalartery
Rightrenalartery
Joinstoiliacartery
Perfusion/endovascularsystemdeliverybranch(removedandoversewnafterintroductionoftheendovasculargraft)
Radiopaquemarkersx9
=radiopaquemarker
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Designedinassociationwith~G. Chad Hughes, MD,AssistantProfessorofSurgery,DirectoroftheThoracicAorticSurgeryProgram,SectionofCardiovascular&ThoracicSurgery,DukeUniversityMedicalCenter,Durham,NC.Richard L. McCann, MD,ProfessorofSurgery,DivisionofGeneralSurgery,VascularSurgery,DukeUniversityMedicalCenter,Durham,NC.
Example of a Completed Abdominal Debranching and Thoracoabdominal Hybrid Procedure
Endovasculargraft
Celiacaxis
Rightrenalartery
Superiormesentericartery
Leftrenalartery
Iliacartery
IllustrationfromHughesGC.et al.9
BoreSizes UsableLengths Catalogue(mm) (cm) No.
A B C D E F A B C D E F 14108866 2525252525257314886/6/10BRM14108888 252525252525 7314888/8/10BRM
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Perfusion/endovascularsystemdeliverybranch
Joinstoaorticarch,abdominalaortaoriliacartery
Aorticarchorrenal/visceralarterybranches
Radiopaquemarker
Trifurcate with Side Branch and Radiopaque Marker
DesignedinassociationwithGiampaolo Zoffoli, MD, DepartmentofCardiovascularSurgery,Ospedaledell’Angelo,Venice,Italy.
Note:BranchBoffsetat30otosectionA.
B
DC
A
E
25o
BoreSizes UsableLengths Catalogue(mm) (cm) No.
A B C D E A B C D E 12101066 1515303030 731206/10/10RM14101077 1515303030 731407/10/10RM16101088 1515303030 731608/10/10RM1610888 1515303030 731608/8/10RM
=radiopaquemarker
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References
1. LumsdenAB.et al.(2007).HybridInterventionsforComplexAortic Pathology.EndovascularToday,November;80–85.
2. BlackSA.et al.(2006).ComplexThoracoabdominalAortic Aneurysms:EndovascularExclusionwithVisceralRevascularization. JournalofVascularSurgery,Vol.43,No.6;1081–1089.
3. ZhouWet al.(2006).HybridApproachtoComplexThoracicAortic AneurysmsinHigh-riskPatients:SurgicalChallengesandClinical Outcomes.JournalofVascularSurgery,Vol.44,No.4;688–693.
4 ChiesaR.et al.(2008).EndovascularTreatmentofAorticArch Aneurysms.JornalVascularBrasileiro,Vol.7,No.2;90–98.
5. MilewskiRK.et al.(2010).HaveHybridProceduresReplacedOpenAorticArchReconstructioninHighRiskPatients?AComparativeStudyofElectiveOpenArchDebranchingwithEndovascularStentGraftPlacementandConventionalElectiveOpenTotalandDistalAorticArchReconstruction.TheJournalofThoracicandCardiovascularSurgery,Vol.140,No.3;590–597.
6. EuropeanPatentNumber:1736116B1.
7. CarroccioAet al.(2005).AorticArchandDescendingThoracic AorticAneurysms:ExperiencewithStentGraftingforSecond-Stage “ElephantTrunk”Repair.Vascular,Vol.13,No.1;5–10.
8. DataonfileatVascutekLtd.
9. HughesGC.etal.(2011).Pan-aorticHybridTreatmentof Mega-aortaSyndrome.JournalofVascularSurgery,Vol.53,No.5; 1398-1401.
ClinicalpapersavailableonrequestfromVascutekLtd.
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