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Case presentation: Relay + 4-fenestration Anaconda case M. Lescan

Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

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Page 1: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Case presentation:Relay + 4-fenestration Anaconda

caseM. Lescan

Page 2: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Disclosure

Speaker name:

Mario Lescan

I have the following potential conflicts of interest to report:

x Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

Other(s)

I do not have any potential conflict of interest

Page 3: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Patient history

• 74 year old male patient

• aneurysm of the thoracoabdominal transition

• diameter progress of 6 mm in 8 months

• coronary artery disease (multiple stents 1998, 2005)

• history of stroke

• chronic occlusion of the right ICA,

50% stenosis left ICA

• Arterial hypertension

Page 4: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Preoperative CT scan

Page 5: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Anatomical challenges and treatment plan

• filiform stenosis of the celiac trunc

• TREATMENT PLAN:

• 1st stage:

Relay TEVAR + cannulation and PTA of the CT

• 2nd stage:

Completion with a 4-fold fenestrated Anaconda and VBX stent grafts

Page 6: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

1st treatment stage

Page 7: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

2nd treatment stage

Material:

• 4-fold Anaconda fenestrated

• Gore VBX:• CT: 9/39 SMA: 9/39

• RRA: 7/29 LRA: 7/19 mm

• Oscor stearable sheath:• 8.5F 55 cm

• 7F 55 cm

• Atlas Gold, Bard • 12/20 mm

Page 8: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

2nd treatment stage

Page 9: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

LRA

Page 10: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

LRA

Page 11: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

LRA

VBX

Before flaring

VBX

After flaring

Page 12: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

RRA

Page 13: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

RRA

Page 14: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

SMA

Page 15: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

SMA

Page 16: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

CT

Page 17: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Completion of the procedure

Page 18: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Completion Angiography

Page 19: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Follow-up after 3 months

Page 20: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Thank You for Your attention!

Page 21: Case presentation: Relay + 4-fenestration Anaconda case · Case presentation: Relay + 4-fenestration Anaconda case M. Lescan. Disclosure Speaker name: Mario Lescan I have the following

Case presentation:Relay + 4-fenestration Anaconda

caseM. Lescan