Expanding the role of covered stents for aneurysmal and stenotic lesions
89
Expanding the role of covered stents for aneurysmal and stenotic lesions M.H.Tenholt Vascular and Endovascular Surgery Theresien Hospital Mannheim - Germany
-
Upload
uvcd -
Category
Presentations & Public Speaking
-
view
161 -
download
0
Transcript of Expanding the role of covered stents for aneurysmal and stenotic lesions
Expanding the role of covered stents for aneurysmal and stenotic lesions
M.H.Tenholt
Vascular and Endovascular Surgery
Theresien Hospital Mannheim - Germany
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Superior patency for iliac stenting
Iliac stenting Patency @12 months 18 months 24 months 60 months
CS 95% BMS 82% Sabri et al CS 92% 92% BMS 78% 62% Bosiers et al CS 91% Dartmouth et al CS 87% BMS 53%Cerezo et al CS 100% 86%
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Renal and visceral stenting Patency at:12 months 24 months 36 months
Renal Mohabbat/Greenberg et al CS 95% BMS 83% Hassis et al CS 100% 93% BMS 83% 74%
Mesenteric Lesar et al CS 100% BMS 54% Oderich et al CS 92% BMS 52%
Superior patency for renal and visceral stenting
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
eCovered stent applications
Trauma cases/ruptures/bail out
Occlusive disease
Aneurysms
Coarctations
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Aneurysms: FEVAR
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
eAneurysms: Ch-EVAR
chimney technique
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Iliac aneurysms
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
eIntroducing
V12
Balloon expandable Steel Totally PTFE covered
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
eIntroducing
V12
Premounted Over 150.000 implants Over 150 publications
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Ability to customize and post-dilate Flexible because of open cell design
Thermo-conformable ePTFE covering
flared end cone shape
flexible design
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
V12 minimizes embolic debris
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
eIn-stent restenosis:
bare metal stent vs covered stent
PTFE stent after 28 days
Uncovered stent after 28 days
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Full range of stents
5 – 22 mm range
5- 11 Fr.
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e66 yearLeriche-Syndrome
Therapy: Stent-Angioplasty in Kissing-Ballon-technique
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
71 yearTasc D lesion
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e62 year
Redo case after com/ext Iliac Stent PTA 2008
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e54 year
Aortic/ Iliac ulcer ,Art.iliaca com re,PAD Rutherford 3
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
K,WF64 pAVK4re, Niereninsuffizienz St.3
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
E,W78 sympt. ACI Stenose
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
E,W78 sympt. ACI Stenose
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e59 year
Aneurysm Right Internal Iliac, dilat. Angiopathy
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
S,R59 Aneurysma Art. Iliaca int re,dilat. Angiopathie
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
S,R59 Aneurysma Art. Iliaca int re,dilat. Angiopathie
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
S,R59 Aneurysma Art. Iliaca int re,dilat. Angiopathie
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
S,R59 Aneurysma Art. Iliaca int re,dilat. Angiopathie
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
S,R59 Aneurysma Art. Iliaca int re,dilat. Angiopathie
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
S,R59 Aneurysma Art. Iliaca int re,dilat. Angiopathie
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e73 year
PAOD Rutherford 2 Aneurysm exclusion in aortobiiliacal position
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e60 year PAOD Rutherford 3 Leriche Syndrom
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e58 yearPAOD Rutherford 2 on both sides
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e66 year
PAOD Rut. 3 bilateral
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
52 yearAV Fistulal VCI after Spondylodesis
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e87 year
High grade in-stent restenosis after carotid stent - 30.09.2011
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e45 year
RezIn Stent restenosis left subclavian artery with subclavian steal Syndrome
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Mat
thia
s.T
enho
lt@th
eres
ienk
rank
enha
us.d
e
Conclusion V12 Covered Stents
Covered stent: not only for acute problems
Covered stents are the prefered implants in aortoiliac occlusive lesions (TASC C & D lesions)
Can be used in plaque ulcerations and small aneurysmal/occlusive lesions
Usefull as a “stent in-stent“ concept in redo cases and they are then preferable to open surgery
Expanding the role of covered stents for aneurysmal and stenotic lesions
Thank you
Dr. M.H.Tenholt
