Whats Needed? Tim Chuter, MB, ChB, MD UCSF, Division of Vascular - PDF document

Feb 21, 2024 •604 likes •738 views

EVAR: What's New? EVAR: Whats New? Whats Needed? Tim Chuter, MB, ChB, MD UCSF, Division of Vascular Surgery 1 EVAR: What's New? Disclosure Cook Medical Patents Grants 2 1 EVAR: What's New? Newer vs. Better 3 EVAR:

EVAR: What's New? EVAR: What’s New? What’s Needed? Tim Chuter, MB, ChB, MD UCSF, Division of Vascular Surgery 1 EVAR: What's New? Disclosure • Cook Medical – Patents – Grants 2 1
EVAR: What's New? Newer vs. Better 3 EVAR: What's New? Device Development • Pre-clinical testing – Replicate the endovasular environment • Clinical testing – Learn from your mistakes 4 2
EVAR: What's New? Flow Related Pressure Related 5 EVAR: What's New? Fabric failure Side of stent Apex of stent Beebe et al JVS 2001;33:S55-S63 6 3
EVAR: What's New? Nitinol Corrosion Heintz C. et al. J Endovasc Ther 2001;8:248-53 7 EVAR: What's New? 8 4
EVAR: What's New? 9 EVAR: What's New? Suprarenal Stent 10 5
EVAR: What's New? Convergent Evolution • Barbed uncovered proximal stent • Polished Nitinol stents • Tightly woven Dacron fabric • Short widely spaced Z-stents 11 EVAR: What's New? The Ustable Neck 12 6
EVAR: What's New? Year 1 Year 4 Year 5 13 EVAR: What's New? Long-Term Follow-Up of Neck Expansion after Endovascular Aortic Aneurysm Repair Thomas S Monahan, Timothy AM Chuter, Linda M Reilly, Joseph H Rapp, and Jade S Hiramoto 14 7
EVAR: What's New? Long-term Zenith • 14-yr freedom from – Aneurysm rupture 98% – Re-intervention 78% 15 EVAR: What's New? 16 8
EVAR: What's New? Zenith Stability • The stent grafts lasted longer than the patients • No large necks • Adherence to IFU 17 EVAR: What's New? Long-Term Data • Zenith • Endurant • Excluder 18 9
EVAR: What's New? Functional Match • Anatomy • Device • Technique 19 EVAR: What's New? Stent-Based 20 10
EVAR: What's New? Polymer-Based 21 EVAR: What's New? Endoanchors 22 11
EVAR: What's New? Fenestrations, Branches 23 EVAR: What's New? What’s Needed • Long-term data (on modern devices) • Quicker pathways to regulatory approval • Lower device cost 24 12

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