New Technique to Facilitate Renal Revascularization with Use of Telescoping Self-Expanding Stent Grafts: VORTEC

Author:

Lachat Mario1,Mayer Dieter1,Criado Frank J.1,Pfammatter Thomas1,Rancic Zoran1,Genoni Michele1,Veith Frank J.1

Affiliation:

1. *Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland; †Department of Vascular Surgery, Union Memorial Hospital-MedStar Health, Baltimore, MD; ‡Department of Interventional Radiology, University Hospital Zurich, Zurich, Switzerland; and §The Cleveland Clinic and New York University Medical Center, New York, NY

Abstract

This article describes a new, less invasive prosthetic graft anastomotic technique that uses self-expanding stent grafts that are “telescoped” into aortic branches. This method, the VORTEC (Viabahn Open Revascularization TEChnique), obviates the need for potentially difficult complete vessel exposure and graft anastomoses, thereby reducing the duration of flow interruption and simplifying the performance of complex aortic reconstructions and so-called debranching procedures requiring reconstruction of major branches such as renal arteries. Minimal exposure of one surface of the renal artery allowed introduction and deployment of a self-expanding Viabahn (W.L. Gore & Associates, Flagstaff, AZ) device using the Seldinger technique. The Viabahn devices used were 5 to 8 mm in diameter and 5 to 15 cm in length depending on individual anatomy (assessed by preoperative computed tomographic angiography). Overall, 82 renal arteries have been revascularized in 58 patients using the VORTEC. The technical success rate was 100%, with all of the stent grafts implanted as intended with maintenance of flow. The patency rates were 97% after 30 days and 96% after a mean follow-up of 18 months (range 1–38 months). The VORTEC allows performance of safe and expeditious revascularization of renal arteries. This new technique may represent significant improvement over the standard approach of surgical exposure and sutured anastomosis.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging,General Medicine,Surgery

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