KMID : 1037520230390020015
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Vascular Specialist International 2023 Volume.39 No. 2 p.15 ~ p.15
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Current Clinical Knowledge on GORE EXCLUDER Conformable Abdominal Aortic Aneurysm Repair Endoprosthesis: A Case Series and Literature Review
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Christos F. Pitros
Fotios O. Efthymiou Andreas L. Tsimpoukis Christos P. Dimitroukas Petros E. Zampakis Konstantinos G. Moulakakis George S. Panayiotakis Stavros K. Kakkos
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Abstract
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The GORE EXCLUDER Conformable abdominal aortic aneurysm (AAA) Endoprosthesis (CEXC), is currently the newest stent-graft system for treating patients with AAA. CEXC is approved for patients with proximal aortic neck angles ¡Â90¡Æ with a ¡Ã15 mm aortic neck length or proximal aortic neck angles ¡Â60¡Æ with ¡Ã10 mm aortic neck length. The present study describes a clinical series of 5 males with AAA, one of whom had a ruptured infrarenal AAA and a 90¡Æ proximal aortic neck angle. All patients were treated with 100% technical success using the CEXC device. Dosimetric data were recorded regarding the total kerma-area product and total fluoroscopy time. During the 30-day follow-up, no device migration or failure was detected, whereas type Ib and II endoleaks were observed in two patients. The type Ib endoleak required re-intervention with limb extension placement, and the type II endoleak was treated with lumbar artery embolization. This clinical series showed that CEXC has no technical defects or AAA-related mortality. We also reviewed the current knowledge on CEXC¡¯s clinical outcomes, showing promising technical and clinical results in some studies, even outside the instructions for use. CEXC expands the vascular surgeons¡¯ armamentarium against hostile neck anatomy, as it is the only repositionable endovascular aneurysm repair device available. Multicenter, long-term outcome studies should confirm the promising preliminary results of our case series and the literature review.
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KEYWORD
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Abdominal aortic aneurysm, Endovascular aortic repair, Ruptured aortic aneurysm, Fluoroscopy, Endoleak
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