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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2017 May 26

DOI: 10.23736/S0021-9509.17.09986-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Initial experience with the E-ventus® stentgraft for endovascular treatment of visceral artery aneurysms

Susanne ANTON 1, Erik STAHLBERG 1, Marco HORN 2, Marcus WIEDNER 2, Markus KLEEMANN 2, Joerg BARKHAUSEN 1, Jan P., GOLTZ 1

1 Clinic for Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; 2 Clinic for Surgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany


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BACKGROUND: To evaluate the safety and efficacy of a novel balloon-expandable stentgraft for endovascular treatment of visceral artery aneurysms (VAA).
METHODS: Between 9/2014 and 1/2017 seven patients (69+/-15y) with true (n=4) and false (n=3) VAAs were treated by implantation of balloon-expandable stentgrafts (E-ventus®, Jotec, Germany) using a trans-femoral (n=2) or –brachial (n=5) vascular access. The stentgraft was placed without prior passing of the landing zone with a sheath. In 3/7 patients (42.9%) additional coil or plug embolization was performed to prevent retrograde VAA perfusion. Endpoints were technical success (defined as delivery and implantation of the stentgraft in the intended position with complete exclusion of the VAA), peri-procedural complications and patency.
RESULTS: Mean diameters of true VAAs (splenic artery: n=2, common hepatic artery: n=1, celiac trunk: n=1) were 26+/-9 and of false (common hepatic artery: n=2, gastroduodenal artery: n=1) 29+/-14mm. False aneurysms presented as emergencies with active bleeding. Technical success was 100%. One peri-procedural complication was noted: pseudoaneurysm of the accessed brachial artery. After a mean follow-up of 187 days 6/7 stentgrafts (85.7%) were patent. One patient (fVAA) died two days after the emergency procedure owing to multi-organ failure which was assessed to be non procedure-related. Another patient (fVAA) died 7 months from the procedure owing to cancer.
CONCLUSIONS: Endovascular treatment of true and false visceral artery aneurysms by use of the E-ventus® stentgraft is safe and effective. Flexibility of the stentgraft and shaft allows for implantation without passing the lesion with a sheath, enabling treatment of distal as well as complex visceral lesions. Long-term results regarding patency in a larger patient cohort are needed to confirm these findings.


KEY WORDS: Visceral artery aneurysm - Endovascular treatment - Stent-graft

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Anton S, Stahlberg E, Horn M, Wiedner M, Kleemann M, Barkhausen J, et al. Initial experience with the E-ventus® stentgraft for endovascular treatment of visceral artery aneurysms. J Cardiovasc Surg 2017 May 26. DOI: 10.23736/S0021-9509.17.09986-4 

Corresponding author e-mail

JanPeter.Goltz@uksh.de