Effectiveness of endovascular repair with fenestration stent and branch stent assisted by 3D printing in treating thoracoabdominal aortic aneurysm involving visceral artery area_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 SUN Yan ¹ , WANG Yutao ² , ZHANG Shiyi ¹ , DONG Dianning ¹ , WU Xuejun ¹

1. Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, P.R.China;
2. Department of Peripheral Vascular Disease, Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan, 250012, P.R.China;

Corresponding author：

SUN Yan, Email: sdxueguan@163.com

Keywords：

3D printing; endovascular repair; aortic aneurysm; fenestration stent; branch stent

DOI：

10.7507/1007-4848.202007014

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical value of in vitro fenestration and branch stent repair in the treatment of thoracoabdominal aortic aneurysm in visceral artery area assisted by 3D printing.Methods The clinical data of 7 patients with thoracoabdominal aortic aneurysm involving visceral artery at the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from March 2016 to May 2019 were analyzed retrospectively. There were 5 males and 2 females with an average age of 70.2±3.9 years. Among them 4 patients had near-renal abdominal aortic aneurysm, 3 had thoracic aortic aneurysm, 4 had asymptomatic aneurysm, 2 had acute symptomatic aneurysm and 1 had threatened rupture of aneurysm. According to the preoperative CT measurement and 3D printing model, fenestration technique was used with Cook Zenith thoracic aortic stents, and branch stents were sewed on the main stents in vitro, and then the stents were modified by beam diameter technique for intracavitary treatment.Results All the 7 patients completed the operation successfully, and a total of 18 branch arteries were reconstructed. The success rate of surgical instrument release was 100.0%. The average operation time was 267.0±38.5 min, the average intraoperative blood loss was 361.0±87.4 mL and the average hospital stay was 16.0±4.2 d. Immediate intraoperative angiography showed that the aneurysms were isolated, and the visceral arteries were unobstructed. Till May 2019, there was no death, stent displacement, stent occlusion, ruptured aneurysm or loss of visceral artery branches. Conclusion 3D printing technology can completely copy the shape of human artery, intuitively present the anatomical structure and position of each branch of the artery, so that the fenestration technique is more accurate and the treatment scheme is more optimized.

Citation： SUN Yan, WANG Yutao, ZHANG Shiyi, DONG Dianning, WU Xuejun. Effectiveness of endovascular repair with fenestration stent and branch stent assisted by 3D printing in treating thoracoabdominal aortic aneurysm involving visceral artery area. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(1): 90-94. doi: 10.7507/1007-4848.202007014 Copy

1.	Coselli JS, Bozinovski J, LeMaire SA. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Ann Thorac Surg, 2007, 83(2): S862-S864.
2.	依地热斯·艾山, 李新喜, 田野, 等. 开窗支架与烟囱技术腔内治疗腹主动脉瘤疗效比较的 Meta 分析. 中国普通外科杂志, 2019, 28(6): 696-705.
3.	朱杰昌, 胡凡果, 张益伟, 等. 台上体外开窗腔内动脉瘤修复术治疗短瘤颈腹主动脉瘤的初步观察. 中华医学杂志, 2016, 96(45): 3642-3646.
4.	Cross J, Gurusamy K, Gadhvi V, et al. Fenestrated endovascular aneurysm repair. Br J Surg, 2012, 99(2): 152-159.
5.	Nordon IM, Hinchliffe RJ, Holt PJ, et al. Modern treatment of juxtarenal abdominal aortic aneurysms with fenestrated endografting and open repair—A systematic review. Eur J Vasc Endovasc Surg, 2009, 38(1): 35-41.
6.	Oderich GS, Correa MP, Mendes BC. Technical aspects of repair of juxtarenal abdominal aortic aneurysms using the Zenith fenestrated endovascular stent graft. J Vasc Surg, 2014, 59(5): 1456-1461.
7.	Kim GB, Lee S, Kim H, et al. Three-dimensional printing: Basic principles and applications in medicine and radiology. Korean J Radiol, 2016, 17(2): 182-197.
8.	刘昭, 童垣皓, 于同, 等. 3D 打印引导下采用开窗或分支支架治疗胸腹主动脉疾病. 中华普通外科杂志, 2019, 34(3): 213-216.
9.	Barón V, Guevara R. Three-dimensional printing-guided fenestrated endovascular aortic aneurysm repair using open source software and physician-modified devices. J Vasc Surg Cases Innov Tech, 2019, 5(4): 566-571.
10.	袁丁, 左萧, 黄斌, 等. 3D 打印技术辅助复杂瘤颈腹主动脉瘤腔内治疗: 附1例报道. 中国普外基础与临床杂志, 2015, 22(1): 96-98.
11.	刘长建, 刘昭. 3D 打印技术引导预开窗治疗复杂主动脉弓部病变. 中国实用外科杂志, 2018, 38(12): 1381-1384.
12.	陈岩, 朱杰昌, 戴向晨, 等. 台上体外开窗技术治疗胸腹主动脉病变. 中华普通外科杂志, 2018, 33(3): 196-200.
13.	Blankensteijn LL, Dijkstra ML, Tielliu IF, et al. Midterm results of the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair. J Vasc Surg, 2017, 65(2): 303-310.
14.	朱杰昌, 戴向晨, 罗宇东, 等. 体外开窗腔内主动脉修复术治疗胸腹主动脉病变的早期结果分析. 中华医学杂志, 2018, 98(12): 921-925.
15.	Banno H, Cochennec F, Marzelle J, et al. Comparison of fenestrated endovascular aneurysm repair and chimney graft techniques for pararenal aortic aneurysm. J Vasc Surg, 2014, 60(1): 31-39.
16.	Donas KP, Bisdas T, Austermann M, et al. The chimney technique has a complementary role in the endovascular repair of juxtarenal aortic aneurysms: There is no need for a paradigm shift but for accurate patient selection. J Endovasc Ther, 2013, 20(4): 584-587.
17.	Verhoeven EL, Vourliotakis G, Bos WT, et al. Fenestrated stent grafting for short-necked and juxtarenal abdominal aortic aneurysm: An 8-year single-centre experience. Eur J Vasc Endovasc Surg, 2010, 39(5): 529-536.
18.	Greenberg RK, Sternbergh WC, Makaroun M, et al. Intermediate results of a United States multicenter trial of fenestrated endograft repair for juxtarenal abdominal aortic aneurysms. J Vasc Surg, 2009, 50(4): 730-737.
19.	Verhoeven EL, Tielliu IF, Bos WT, et al. Present and future of branched stent grafts in thoraco-abdominal aortic aneurysm repair: A single-centre experience. Eur J Vasc Endovasc Surg, 2009, 38(2): 155-161.

1. Coselli JS, Bozinovski J, LeMaire SA. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Ann Thorac Surg, 2007, 83(2): S862-S864.
2. 依地热斯·艾山, 李新喜, 田野, 等. 开窗支架与烟囱技术腔内治疗腹主动脉瘤疗效比较的 Meta 分析. 中国普通外科杂志, 2019, 28(6): 696-705.
3. 朱杰昌, 胡凡果, 张益伟, 等. 台上体外开窗腔内动脉瘤修复术治疗短瘤颈腹主动脉瘤的初步观察. 中华医学杂志, 2016, 96(45): 3642-3646.
4. Cross J, Gurusamy K, Gadhvi V, et al. Fenestrated endovascular aneurysm repair. Br J Surg, 2012, 99(2): 152-159.
5. Nordon IM, Hinchliffe RJ, Holt PJ, et al. Modern treatment of juxtarenal abdominal aortic aneurysms with fenestrated endografting and open repair—A systematic review. Eur J Vasc Endovasc Surg, 2009, 38(1): 35-41.
6. Oderich GS, Correa MP, Mendes BC. Technical aspects of repair of juxtarenal abdominal aortic aneurysms using the Zenith fenestrated endovascular stent graft. J Vasc Surg, 2014, 59(5): 1456-1461.
7. Kim GB, Lee S, Kim H, et al. Three-dimensional printing: Basic principles and applications in medicine and radiology. Korean J Radiol, 2016, 17(2): 182-197.
8. 刘昭, 童垣皓, 于同, 等. 3D 打印引导下采用开窗或分支支架治疗胸腹主动脉疾病. 中华普通外科杂志, 2019, 34(3): 213-216.
9. Barón V, Guevara R. Three-dimensional printing-guided fenestrated endovascular aortic aneurysm repair using open source software and physician-modified devices. J Vasc Surg Cases Innov Tech, 2019, 5(4): 566-571.
10. 袁丁, 左萧, 黄斌, 等. 3D 打印技术辅助复杂瘤颈腹主动脉瘤腔内治疗: 附1例报道. 中国普外基础与临床杂志, 2015, 22(1): 96-98.
11. 刘长建, 刘昭. 3D 打印技术引导预开窗治疗复杂主动脉弓部病变. 中国实用外科杂志, 2018, 38(12): 1381-1384.
12. 陈岩, 朱杰昌, 戴向晨, 等. 台上体外开窗技术治疗胸腹主动脉病变. 中华普通外科杂志, 2018, 33(3): 196-200.
13. Blankensteijn LL, Dijkstra ML, Tielliu IF, et al. Midterm results of the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair. J Vasc Surg, 2017, 65(2): 303-310.
14. 朱杰昌, 戴向晨, 罗宇东, 等. 体外开窗腔内主动脉修复术治疗胸腹主动脉病变的早期结果分析. 中华医学杂志, 2018, 98(12): 921-925.
15. Banno H, Cochennec F, Marzelle J, et al. Comparison of fenestrated endovascular aneurysm repair and chimney graft techniques for pararenal aortic aneurysm. J Vasc Surg, 2014, 60(1): 31-39.
16. Donas KP, Bisdas T, Austermann M, et al. The chimney technique has a complementary role in the endovascular repair of juxtarenal aortic aneurysms: There is no need for a paradigm shift but for accurate patient selection. J Endovasc Ther, 2013, 20(4): 584-587.
17. Verhoeven EL, Vourliotakis G, Bos WT, et al. Fenestrated stent grafting for short-necked and juxtarenal abdominal aortic aneurysm: An 8-year single-centre experience. Eur J Vasc Endovasc Surg, 2010, 39(5): 529-536.
18. Greenberg RK, Sternbergh WC, Makaroun M, et al. Intermediate results of a United States multicenter trial of fenestrated endograft repair for juxtarenal abdominal aortic aneurysms. J Vasc Surg, 2009, 50(4): 730-737.
19. Verhoeven EL, Tielliu IF, Bos WT, et al. Present and future of branched stent grafts in thoraco-abdominal aortic aneurysm repair: A single-centre experience. Eur J Vasc Endovasc Surg, 2009, 38(2): 155-161.

Previous Article
Treatment of supracardiac total anomalous pulmonary venous connection in a single center
Next Article
Imaging evaluation of liver cancer after local-regional therapy

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effectiveness of endovascular repair with fenestration stent and branch stent assisted by 3D printing in treating thoracoabdominal aortic aneurysm involving visceral artery area

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content