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EVAR Overview and stent-graft implantation in complex iliac anatomy

EVAR Overview and stent-graft implantation in complex iliac anatomy. Angiomed Workshop Deineka Conference Room 22TH JUNE 2019 Dr. G. Kalender DRK Kliniken Berlin. Anaconda Stentgraft. modular design flexible safe repositionable easily probed with magnet wire. Indications.

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EVAR Overview and stent-graft implantation in complex iliac anatomy

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  1. EVAR Overview and stent-graft implantation in complex iliac anatomy Angiomed Workshop Deineka Conference Room 22TH JUNE 2019 Dr. G. KalenderDRK Kliniken Berlin

  2. Anaconda Stentgraft • modular design • flexible • safe • repositionable • easilyprobedwithmagnetwire Dr. G. Kalender

  3. Indications MorphologysuitableforEndovascularAneurysmRepair (EVAR) Proximal aortic neck lengthof≥15mm with non-significantcalcificationand/orthrombus Native proximal neck diameter17,5- 31 mm Anaconda™ ONE-LOK™ Adequateiliacorfemoralvesselaccess Native iliacarterydiametersof8,5- 21 mm Distal Fixation LengthOf ≥20mm Dr. G. Kalender

  4. Modular concept wide range of main bodys and iliac legs durable ultrathin- polyester ring- stent design (nitinol) Dr. G. Kalender

  5. bifurcated main body proximal ring contralateral radiopaque markers secondary ring valley hooks peek hooks leg docking radiopaque distal radiopaque marker contralateral cannulation flare with radiopaque markers Dr. G. Kalender

  6. Iliac leg proximal radiopaque marker individual ring stents with radiopaque alignment markers distal radiopaque marker Dr. G. Kalender

  7. Iliac leg – flared und tapered proximal radiopaque marker transition marker distal radiopaque marker Dr. G. Kalender

  8. fast and easy cannulation patentedmagnetwirecannulation Dr. G. Kalender

  9. Fully repositionable Dr. G. Kalender

  10. Range of sizes • bifurcated main body • diameter 21,5 – 34 mm • length 65 mm • Iliac leg • diameter 10 – 23 mm • length 60 – 140 mm Dr. G. Kalender

  11. Anaconda Stentgraft System NEW ONE-LOK™ BODY: Additional ring stents: maximizethelumen und bloodflow large lumenforipsilateralcannulation standarddiameter in thedockingzone indicated to treat infra-renal neck angulations > 90° Dr. G. Kalender

  12. 12 Proactive Sealing System Excellent sealing function - dual, proximal ring stent design with hooks - security against stent graft migration Dr. G. Kalender

  13. FDA Clinical Trial Phase II One Year Results of the Vascutek Anaconda™. ONE-LOK EVAR trial. Christopher Kwolek, MD. Randy Moore, MD. On behalf of the Anaconda™ Investigators  23 hospitals (18 USA, 5 Canada), 195 patients, >15 mm neck of aneurysm, <60° angulation 98 % technical success, no conversion 0% mortality, 100 % open iliac leg 98% no endoleak Typ I oder III Typ II endoleak: 32 % (30 Tagen), 26% (1Jahr) summary: Anaconda- stentgraft- safe and effektive after 12 months Dr. G. Kalender

  14. Fenestrated Anaconda™ • Body sectionwithoutstents: • maximise the available area for fenestrations • optimal flexibility for varying patient anatomies • fullyrepositionablesystemfor optimal positioning • nodeformationoffenestrationbystent material Dr. G. Kalender

  15. Fenestrated Anaconda™ patented magnet system: significantly reduce bifurcate body cannulation time dual proximal ring stent design with hooks provides excellent sealing function multiple independent ring stent design provides maximum flexibility for varying patient anatomies minimises the potential for kinking Dr. G. Kalender

  16. Fenestrated Anaconda™ > 3000 implantations > 8000 targetvessels since 06/2010 VacutekTerumo News, fenestratedanaconda, Jahrgang XVIV 2015 Dr. G. Kalender

  17. Custom Made LegExample Concepts Dr. G. Kalender

  18. Design Possibilitys Sealingring, Hooks, Fenestrations… Dr. G. Kalender

  19. Access Possibilitys Dr. G. Kalender

  20. POST-OP Pictures Dr. G. Kalender

  21. Device Customisations Pleating • Reduces fabric in region of aortic narrowing Dr. G. Kalender

  22. Additional Fenestration Support Tapered Graft • Helps to alleviate excess fabric overlapping with fenestrations • Reduces the fabric diameter in cases of more extreme narrowing Dr. G. Kalender

  23. Flared Graft Extra-long Body • Increases the fabric diameter in cases of more extreme widening • 90-100mm long. Required joining ring to attach two pieces of fabric together and the contralateral flare is removed. Dr. G. Kalender

  24. Legs Lateral • Useful when close to the bifurcation of an existing device or aorta Dr. G. Kalender

  25. Dr. G. Kalender

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