Summer 2005

Fenestrations Give View to Future of Stent Grafts

About 400 of the fenestrated stent graft procedures have been done worldwide, mostly in Australia and Europe, but the device doesn't yet have U.S. Food and Drug Administation approval, but UCSF has been designated as one of six medical centers -- and the only one west of the Mississippi River -- to take part in an initial FDA feasibility study of the fenestrated stent graft. The first three patients in this national study have been enrolled and treated at UCSF Medical Center.

The procedure is technically demanding, says UCSF surgeon and principal investigator, Darren Schneider, M.D. "You have to perfectly align the aortic stent graft with the renal arteries and thread catheters into each renal artery while holding the stent graft in place," Schneider says. "It requires some pretty advanced endovascular skills, and this procedure probably will never be performed as widely as are procedures that use currently approved stent grafts."

Vascular surgeons at UCSF have long been at the forefront of developing and testing new catheter-based endovascular procedures. Two years ago, Schneider and his UCSF colleague, Timothy Chuter, M.D., were the first surgeons in the United States to repair an aneurysm of the aortic arch without opening the patient's chest. The investigational device was provided on a compassionate-use basis.

Chuter has also developed other stent graft devices with multiple branches to treat complex thoracoabdominal aortic aneurysms, which typically involve critical arterial branches leading to abdominal organs.

To contact Dr. Darren Schneider, call (415) 353-4366.

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