Fenestrated Grafts Offer Patients With Abdominal Aortic Aneurysm a New Option



Abdominal aortic aneurysm occurs when a weakness in the main blood vessel in the abdomen causes it to expand like a balloon. If untreated, the balloon may pop, flooding the chest cavity with blood, often with fatal results. Generally caused by atherosclerosis, the condition is relatively common in the U. S., where it is the thirteenth leading cause of death. Endovascular aneurysm repair (EVAR), a minimally invasive procedure offering patients the advantages of reduced trauma and quicker recovery, is fast becoming the treatment of choice to address this life-threatening problem.

However, some patients are currently denied EVAR because they have an aneurysm with a short neck, meaning that the passage between the aneurysm and the aorta is small, which makes successful stenting difficult. Today at the 33rd annual VEITHsymposium's8482;, Dr. Roy K. Greenberg, the Director of the Endovascular Research and Peripheral Vascular Core Laboratory at Cleveland Clinic (Cleveland, Ohio), discussed the use of fenestrated grafts as an easy and effective solution for providing EVAR to patients with problematic aneurysm anatomy.

Dr. Greenberg began by noting that standard endografts are approved for use only to treat abdominal aortic aneurysm with adequate next length. In addition, when aneurysms extend close to the renal and superior mesenteric arteries, further stenting is required to enable the critical flow of blood to the kidneys and bowels.

Fenestrated devices, which can be custom-fit to the particular anatomy of any aneurysm, use openings intended to extend the fixation zone above the renal arteries, ensuring a better sealing zone to prevent deadly leaks. These devices have been shown to be durable, with complication rates comparing favorably to open surgical repair. However, given the custom manufacturing required for each device, questions remain regarding the feasibility of widespread adoption of the technology.

Greenberg said, Similar technologies are being applied to thoracic aneurysms that abut the arteries to the upper extremities and brain, as well as for thoracic aneurysms that come close to the abdominal vessels.

About VEITHsymposium's8482;
Now entering its fourth decade, VEITHsymposium's8482; provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The five-day event features 300 rapid-fire presentations from the world'ss most renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques.

Cleveland Clinic does not endorse any products or companies. Dr. Greenberg receives research support, consulting fees and has intellectual property licensed to Cook Incorporated (Cook). In addition, both Dr. Greenberg and Cleveland Clinic receive royalty payments from Cook in connection with the sales of one of its products.





Fenestrated Grafts Offer Patients With Abdominal Aortic Aneurysm a New Option





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