EVAR Overview and stentgraft implantation in complex iliac

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

Anaconda Stentgraft § modular design § flexible § safe § repositionable § easily probed with magnet wire 22. 06. 2019 Dr. G. Kalender

Indications §Morphology suitable for Endovascular Aneurysm Repair (EVAR) §Proximal aortic neck length of ≥ 15 mm §with non-significant calcification and/or thrombus § § §Native proximal neck diameter 17, 5 - 31 mm Anaconda™ ONE-LOK™ §Adequate iliac or femoral vessel access §Native iliac artery diameters of 8, 5 - 21 mm § §Distal Fixation Length Of ≥ 20 mm 22. 06. 2019 Dr. G. Kalender

Modular concept §wide range of main bodys and iliac legs §durable ultrathin- polyester §ring- stent design (nitinol) 22. 06. 2019 Dr. G. Kalender

bifurcated main body proximal ring contralateral radiopaque markers secondary ring valley hooks peek hooks leg docking radiopaque distal radiopaque marker 22. 06. 2019 contralateral cannulation flare with radiopaque markers Dr. G. Kalender

Iliac leg proximal radiopaque marker individual ring stents with radiopaque alignment markers distal radiopaque marker 22. 06. 2019 Dr. G. Kalender

Iliac leg – flared und tapered proximal radiopaque marker transition marker distal radiopaque marker 22. 06. 2019 Dr. G. Kalender

fast and easy cannulation patented magnet wire cannulation 22. 06. 2019 Dr. G. Kalender

Fully repositionable 22. 06. 2019 Dr. G. Kalender

Range of sizes • bifurcated main body – diameter – length 21, 5 – 34 mm 65 mm • Iliac leg – diameter – length 22. 06. 2019 10 – 23 mm 60 – 140 mm Dr. G. Kalender

Anaconda Stentgraft System §NEW ONE-LOK™ BODY: §Additional ring stents: §maximize the lumen und blood flow §large lumen for ipsilateral cannulation §standard diameter in the docking zone §indicated to treat infra-renal neck angulations > 90° 22. 06. 2019 Dr. G. Kalender

12 Proactive Sealing System Excellent sealing function - dual, proximal ring stent design with hooks - security against stent graft migration 22. 06. 2019 Dr. G. Kalender

FDA Clinical Trial Phase II § One Year Results of the Vascutek Anaconda™. ONELOK 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% (1 Jahr) § summary: Anaconda- stentgraft- safe and effektive after 12 months 22. 06. 2019 Dr. G. Kalender

Fenestrated Anaconda™ §Body section without stents: § maximise the available area for fenestrations § optimal flexibility for varying patient anatomies §fully repositionable system for optimal positioning §no deformation of fenestration by stent material 22. 06. 2019 Dr. G. Kalender

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 22. 06. 2019 Dr. G. Kalender

Fenestrated Anaconda™ §> 3000 implantations § §> 8000 target vessels § since 06/2010 §Vacutek Terumo News, fenestrated anaconda, Jahrgang XVIV 2015 22. 06. 2019 Dr. G. Kalender

Custom Made Leg Example Concepts 22. 06. 2019 Dr. G. Kalender

Design Possibilitys Sealingring, Hooks, Fenestrations… 22. 06. 2019 Dr. G. Kalender

Access Possibilitys 22. 06. 2019 Dr. G. Kalender

POST-OP Pictures 22. 06. 2019 Dr. G. Kalender

Device Customisations Pleating • 22. 06. 2019 Reduces fabric in region of aortic narrowing Dr. G. Kalender

Additional Fenestration Support • 22. 06. 2019 Helps to alleviate excess fabric overlapping with fenestrations Tapered Graft • Reduces the fabric diameter in cases of more extreme narrowing Dr. G. Kalender

Flared Graft • 22. 06. 2019 Increases the fabric diameter in cases of more extreme widening Extra-long Body • 90 -100 mm long. Required joining ring to attach two pieces of fabric together and the contralateral flare is removed. Dr. G. Kalender

Legs Lateral • 22. 06. 2019 Useful when close to the bifurcation of an existing device or aorta Dr. G. Kalender

22. 06. 2019 Dr. G. Kalender