OFF-THE SELF TREATMENT OF
AORTIC ARCH PATHOLOGIES
WITH NEXUS
Prof. M. Antonello MD, PhD
Department of Cardiac, Thoracic, Vascular Sciences and Public Health
Vascular and Endovascular Surgery Section, University of Padua
Disclosure
Speaker name:
Michele Antonello
I have the following potential conflicts of interest to report:
x Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
Ordering information
Diameter (mm) Length(mm)Branch
14
20
17
30
20
40
Main Body
32
180
36
180
40
180
44
180
Diameter (mm) Length(mm)Oriented
36
40
40
55
43
70
Ascending Module*
* all possible combinations of
diameter and length are available
JT-BR-0050200-EN V01 12/ 2019
JOTEC GmbH, a fully owned subsidiary of CryoLife, Inc. Lotzenäcker 23 • 72379 Hechingen, Germany P +49 (0)7471 922-0 • F +49 (0)7471 922-100 info.europe@cryolife.com • www.jotec.com © 2019 JOTEC GmbH, Germany. All rights reserved.
EU Authorized Representive:
MedNet GmbH, Borkstrasse 10, 48163 Münster, Germany
CryoLife, Inc. • 1655 Roberts Blvd., NW • Kennesaw, GA 30144 • USA P +1 770 419-3355 • +1 800 438-8285 • F +1 770 590-3739 CustomerService@cryolife.com • www.cryolife.com
Main Module*
NEXUS
TMAortic Arch Stent Graft System is
available in a range of sizes that can adapt
to a wide range of anatomies.
NEXUS™ Anatomical indications
Ascending Aorta
• Diameter of 29-39 mm
• Landing zone length of at least 30 mm
Descending Aorta
• Diameter of 26-40 mm
• Landing zone length of at least 30 mm
Brachiocephalic trunk
• Diameter of 11.5-18.5 mm
• Landing zone length of at least 20 mm
• Take off angle between the brachiocephalic artery and
the
a
ortic
a
r
ch
perpendicula
r
should
be
≥
1
25°
NEXUS
TM– the only CE marked endovascular branch system
for the aortic arch. Ready when you are!
Endospan Ltd.
Maskit St. 4, Herzlia Business Park, Herzlia, ISRAEL 46733
Branch Diameter
Main Body Diameter
Diameter
Branch
Length
Length
Main Body
Length
M ain module
Ascending module
?°
90°
NEXUS ENDOGRAFT
Ordering information
Diameter
(mm)
Length
(mm)
Branch
14
20
17
30
20
40
Main Body
32
180
36
180
40
180
44
180
Diameter
(mm)
Length
(mm)
Oriented
36
40
40
55
43
70
Ascending Module*
* all possible combinations of
diameter and length are available
JT-BR-0050200-EN V01 12/ 2019
JOTEC GmbH, a fully owned subsidiary of CryoLife, Inc. Lotzenäcker 23 • 72379 Hechingen, Germany P +49 (0)7471 922-0 • F +49 (0)7471 922-100 info.europe@cryolife.com • www.jotec.com © 2019 JOTEC GmbH, Germany. All rights reserved.
EU Authorized Representive:
MedNet GmbH, Borkstrasse 10, 48163 Münster, Germany
CryoLife, Inc. • 1655 Roberts Blvd., NW • Kennesaw, GA 30144 • USA P +1 770 419-3355 • +1 800 438-8285 • F +1 770 590-3739 CustomerService@cryolife.com • www.cryolife.com
Main Module*
NEXUS
TMAortic Arch Stent Graft System is
available in a range of sizes that can adapt
to a wide range of anatomies.
NEXUS™ Anatomical indications
Ascending Aorta
• Diameter of 29-39 mm
• Landing zone length of at least 30 mm
Descending Aorta
• Diameter of 26-40 mm
• Landing zone length of at least 30 mm
Brachiocephalic trunk
• Diameter of 11.5-18.5 mm
• Landing zone length of at least 20 mm
• Take off angle between the brachiocephalic artery and
the
a
ortic
a
r
ch
perpendicula
r
should
be
≥
1
25°
NEXUS
TM– the only CE marked endovascular branch system
for the aortic arch. Ready when you are!
Endospan Ltd.
Maskit St. 4, Herzlia Business Park, Herzlia, ISRAEL 46733
Branch Diameter
Main Body Diameter
Diameter
Branch
Length
Length
Main Body
Length
M ain module
Ascending module
?°
90°
-
Bilateral femoral percutaneous access
-
Left axillary artery percutaneous access
-
Femoral vein access for rapid pacing
-
Brachial femoral through and trough
system
Main module deployed in the LSA
URGENT CASE
✓ 66 yrs, M
✓ Thoracic Back Pain, Hypertension
(210/110 mmHg)
✓ 2005 Surgery for Type A Dissection
✓ 2007 Appendicitis with peritonitis
✓ 2008 T.I.A.
'
'
URGENT CASE: PLANNING
Patient rIdentifie: Date ofbirth: Potential Implantation Date: Physician N ame: H ospital:
Evaluated by: Confir
m
ed Implantat ion Date:
Date CT/MRI: Slice thickness:
City: Country:
Comment s
Planning Summary
Arch Type: Pat hology:
Length Outer ASC = (≥ 50 mm)
Ø ASC SPS = (≥ 29 mm) Ø Dist. ASC = Ø Mid ASC = Ø Prox. ASC = mm Crit eria Meassure R CFA 20F ≥ 7mm L CFA 20F ≥ 7mm R Brachial Artery 7F ≥ 2.3mm Access Vessels Pat hology Max Ø = Alpha Angle (≥ 125°)
Arch View Project ion BCA View Project ion
Lengt h BCA = (≥ 20 mm)
Length Inner ASC = (≥ 30 mm)
(26 - 40 mm) Ø Prox. DESC = Ø Dist. DESC = Lengt h DESC = Coverage from BCT to descending thoracic aorta ?° 90° Ø RSCA = Ø Dist. BCA = Ø Mid BCA = Ø Prox. BCA =
Main module Ø Branch (mm) Branch lengt h (mm) Ø Body (mm) Body lengt h (mm) ESN 200M SCP ESN 200M SCP
Ascend ing Ø ASC(mm) ASC lengt h(mm)
ESN 200ASC ESN 200ASC
by End osp an Lt d.
CASE Ident ifie
r : 180 180 º º º
Ascend ing Aort a (29 - 39 mm) BCA (11.5 - 18.5 mm)
Ordering Informat ion
Date ofAssessment: º º Assessment IFU IT-PADO-PAOU-D'O-13-04-54 13/04/1954 Lorenzo Cagliani 21/09/2020 23/09/2020 Augusto D'Onofrio 12.7 18.4 17.6 17.4 31 32 32 37
Suggest 24F x 65cm access sheath - tortuous, narrow aortic anatomy Thrombus in distal Asc Aorta & BCA - suggest EPD Intra Op pigtail to determine length of Asc required.
Narrow TL zones 1-4 - suggest deployment of NEXUS Arch graft beyon the Dock be performed under rapid cardiac pacing
9.8 149 9.2 9.2 40 90 180 26 180 0.50 21/09/2020
University Hospital Padova Padova Italy
25 25 50 35 23/09/2020 IT-PADO-PAOU-D'O-13-04-54 20 20 36 36 36 55 40 LAO Cranial Cranial LAO
Dissection Type II, Bovine
IFU
