CASE STUDY
MULTIDISCIPLINARY STAGED ENDOVASCULAR REPAIR OF THE AORTIC ARCH WITH NEXUS™
A, B, C: aortic enlargement following open ascending aorta replacement as seen on the computed tomography angiogram performed to allow procedural planning.
3-dimensional reconstructions generated from the preoperative and discharge computed tomography angiography illustrating arch type, pathology, and flexible adaption of the NEXUS™ Stent Graft System.
PATIENT INFORMATION
An 81-year-old male patient with previous surgical ascending aortic repair, gothic arch, and systemic vascular pathology.
REASON TO TREAT
Aortic aneurysm from distal ascending anastomosis to celiac trunk varying in diameter from 39-58 mm. Due to the combination of challenges with the anatomy and patient’s general condition, the
multidisciplinary team discussed and decided the most suitable solution would be to use the NEXUS™ Aortic Arch Stent Graft System.
DEBRANCHING
Extra anatomic bypass from the right carotid to the left carotid and left subclavian artery with additional embolization of the proximal segment of the left subclavian artery.
NEXUS IMPLANTATION
The endovascular procedure was successfully performed the following day implanting the NEXUS™ Aortic Stent Graft System excluding the zone 0/1 aneurysm.
PROCEDURAL OUTCOME
Distal extension to exclude the remaining aneurysmal segment of the descending aorta was delayed allowing build-up of collateral flow to mitigate SCI risk.
PHYSICIAN'S PUBLISHED COMMENTS
“The device has several advantages, and it is a game changer. The risk of cerebral events is minimized due to less manipulations, the dedicated ascending prosthesis is ideal for the hemodynamics of the
aorta above the valve and the off-the-shelf character of the endograft increases overall applicability. The total implantation of 56 minutes and the mild sedation confirms the revolutionary and efficient design of the device. The perfusion of the super aortic vessels through a single branch seems awkward for most of the physicians but looking at the long-term data of such bypasses, it seems that this feeling is matter of mindset. Though, further assessment of the durability of the procedure remains mandatory.”
Interventional Radiology &
Cardiovascular Department,
Aretaeio Hospital
Nicosia, Cyprus
Nikolas Charalambous, MD
Theodosios Bisdas, MD
George Kanellopoulos, MD
Neophytos Zambas, MD
Interventional Radiologist
Aretaeio Hospital, Nicosia
Vascular Surgeon
Athens Medical Centre
Cardiac & Thoracic Surgeon
Aretaeio Hospital, Nicosia
Vascular Surgeon
Aretaeio Hospital, Nicosia
CAUTION: Investigational Device – Limited by United States law to investigational use. Endospan devices bear the CE marking of conformity.