EVARのTechnical Tips:Gore Excluder®を中心としたTips

概要

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In recent EVAR procedures, non-IFU cases are also being performed. In EVAR, proximal neck fixation is the most important point in every case. This article shows several techniques and tips of trying EVAR in difficult short neck and angled neck cases, especially in Gore Excluder®.<BR>Endowedge techniques (EWT) including non-sheath assisted, EWT with sheath assisted manners are presented.<BR>Scrum technique is a special technique that is only feasible in Gore Excluder®. The name is derived from rugby's scrummage. By pushing from both sides of a pull through guide wire, the proximal portion of the stentgraft is bent. This technique is applicable in very angled neck cases.<BR>Scrum with Endowege technique is a more precise deployment in short and angle neck cases. In shaggy aorta cases guide wires and stentgraft dialator have the risk of thrombo-embolic complications, and in this case wire-bending technique is applied. This manner reduces thromboembolism from a shaggy descending aorta.<BR>Kilt technique is also a special technique for dumb-bell shape of infra-renal neck configuration. Also troublesome cases include limb occlusion caused by weak points in Excluder® body and legs. The very rare complication of stentgraft collapse is also presented.
一般社団法人日本インターベンショナルラジオロジー学会の論文