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Author(s) -
Francisco Marcos
Publication year - 2017
Publication title -
journal of vascular surgery cases and innovative techniques
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.274
H-Index - 5
ISSN - 2468-4287
DOI - 10.1016/j.jvscit.2016.10.003
Subject(s) - stent , context (archaeology) , medicine , trimming , endovascular surgery , surgery , medical physics , computer science , operating system , paleontology , biology
We sincerely appreciate the insightful comments of Drs Ysa and Mikelarena on our paper “Endograft limb trimming and resheathing can be an alternative for emergent aortic repair without adequate stent graft availability.” Their interest and kind comments offer an excellent opportunity to further explain the technique applied and its potential limitations. A word of caution has to precede any further details on our procedure as we strongly believe that tabletop modifications of commercially available endovascular devices are justifiable only in the context of emergent setups without a valid alternative. This being said, our department sports an experimental surgery program in anatomic and animal models hosted by the Centro Tecnológico de Formación of INIBIC (A Coruña Institute for Biomedical Research). The experience gained in this laboratory has enhanced our knowledge of the device’s limits and behavior in a variety of uncommon situations, encouraging us to apply some slight device modifications in very particular clinical scenarios, as reported. Concerning Endurant iliac limbs (Medtronic, Fridley, Minn), we have been able to fully deploy and resheath them after inversion and compression with a stainless steel wire from a sternal suture (Ethicon, Somerville, NJ). We have also removed a variable number of stent graft sections without a full deployment on a sterile side table, holding within the delivery system the remaining portion to be implanted. This allows the arrangement of different covered cuffs of various

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