F1000Research (Nov 2024)
A Revolutionary Device for Endovascular Aortic Repair of Abdominal Aortic Aneurysm: A Pilot Study [version 2; peer review: 2 approved]
Abstract
Background Endovascular repair for abdominal aortic aneurysms (AAA) has been the gold standard since it was established in 1991. Various graft configurations have been developed to overcome the limitations of endovascular aortic repair (EVAR), including contralateral gate cannulation (CGC). We propose a new device and technique intended to simplify endovascular AAA repair, along with reports of its application in six patients. Intervention The Taofan and Kang (T&K) bidirectional endovascular aortic repair (B-EVAR (B-EVAR) device uses a main-body stent graft, two-limb extensions, and bare metal stent. The procedure involved accessing the right and left femoral arteries, followed by standard aortography evaluation using a pigtail catheter through the contralateral femoral access. The main body stent graft is deployed through ipsilateral femoral access using a balloon catheter, while the contralateral gate is cannulated with a hydrophilic coated wire. Both balloons were inflated simultaneously to ensure that the wires were in different lumens. Contralateral and ipsilateral extensions were deployed using a limb extension stent graft. Standard aortography evaluation was repeated. Result T&K B-EVAR pilot procedures proved successful in various cases, from simple to complex anatomy, and even with varied graft stent deployment strategies. None of the patients had complications or prolonged length of stay (LOS). Follow-up CT did not reveal any high-pressure endoleaks. Conclusion T&K B-EVAR has been proven to simplify endovascular AAA repair in six patients with excellent results. It is also reproducible, potentially universally applicable, and can offer operators ease of use, faster procedure times, reduced fluoroscopy times, and reduced contrast usage.
