Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification
The increasing age of patients with end-stage renal disease raises the issue of hostile arterial access for transplantation, with technical difficulties associated with clamping and suturing the iliac artery. Some of these patients - who theoretically represent those who would benefit the most from...
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Frontiers Media S.A.
2025-01-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13486/full |
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| author | Matthieu Arsicot Matthieu Arsicot Raffaele Pio Ammollo Marine Bordet Marine Bordet Leila Dehina-Khenniche Olivier Thaunat Nellie Della Schiava Nellie Della Schiava Antoine Millon Emilien Seizilles De Mazancourt Lionel Badet Xavier Matillon |
| author_facet | Matthieu Arsicot Matthieu Arsicot Raffaele Pio Ammollo Marine Bordet Marine Bordet Leila Dehina-Khenniche Olivier Thaunat Nellie Della Schiava Nellie Della Schiava Antoine Millon Emilien Seizilles De Mazancourt Lionel Badet Xavier Matillon |
| author_sort | Matthieu Arsicot |
| collection | DOAJ |
| description | The increasing age of patients with end-stage renal disease raises the issue of hostile arterial access for transplantation, with technical difficulties associated with clamping and suturing the iliac artery. Some of these patients - who theoretically represent those who would benefit the most from transplantation in terms of mortality - are contraindicated because of anatomical and medical issues. In this context, a specific endovascular device called EndoPreKiT (Endovascular Preparation for Kidney Transplantation) has been designed, enabling arterial access for transplantation via a mini-invasive procedure. It consists of a woven Dacron supported by self-expanding nitinol rings, ensuring anchorage and allowing arterial clamping. The middle part of the anterior face of the device is stentless, enabling the anastomosis directly onto the Dacron once the calcified artery wall has been removed. After a cadaveric study validating its technical feasibility, such device was successfully implanted in 10 patients considered unfit for transplantation due to severe wall calcification. Two of them have been successfully transplanted with excellent outcomes after 13 and 3 months of follow-up. EndoPreKiT device may be a significant breakthrough in transplant surgery, that could expand the horizon of eligibility to include even the most fragile patients with challenging arterial access. |
| format | Article |
| id | doaj-art-d6aadb6d65b64dbe969b34a3304ed902 |
| institution | Kabale University |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj-art-d6aadb6d65b64dbe969b34a3304ed9022025-01-08T16:52:38ZengFrontiers Media S.A.Transplant International1432-22772025-01-013710.3389/ti.2024.1348613486Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac CalcificationMatthieu Arsicot0Matthieu Arsicot1Raffaele Pio Ammollo2Marine Bordet3Marine Bordet4Leila Dehina-Khenniche5Olivier Thaunat6Nellie Della Schiava7Nellie Della Schiava8Antoine Millon9Emilien Seizilles De Mazancourt10Lionel Badet11Xavier Matillon12Service de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, Lyon, FranceCentre de Référence des Infections Vasculaire Complexes (CRIVasc Network), Hospices Civils de Lyon, Lyon, FranceService de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, Lyon, FranceService de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, Lyon, FranceLaboratoire de Genie Electrique et Ferroélectrique (LGEF), Institut National des Sciences Applicquées (INSA)-Lyon, University Lyon, Villeurbanne, FranceService de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, Lyon, FranceService de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, FranceService de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, Lyon, FranceLaboratoire de Genie Electrique et Ferroélectrique (LGEF), Institut National des Sciences Applicquées (INSA)-Lyon, University Lyon, Villeurbanne, FranceService de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, Lyon, FranceService d’Urologie, Hôpital Saint Louis, Paris, FranceService d’Urologie et de Transplantation, Hospices Civils de Lyon, Lyon, FranceService d’Urologie et de Transplantation, Hospices Civils de Lyon, Lyon, FranceThe increasing age of patients with end-stage renal disease raises the issue of hostile arterial access for transplantation, with technical difficulties associated with clamping and suturing the iliac artery. Some of these patients - who theoretically represent those who would benefit the most from transplantation in terms of mortality - are contraindicated because of anatomical and medical issues. In this context, a specific endovascular device called EndoPreKiT (Endovascular Preparation for Kidney Transplantation) has been designed, enabling arterial access for transplantation via a mini-invasive procedure. It consists of a woven Dacron supported by self-expanding nitinol rings, ensuring anchorage and allowing arterial clamping. The middle part of the anterior face of the device is stentless, enabling the anastomosis directly onto the Dacron once the calcified artery wall has been removed. After a cadaveric study validating its technical feasibility, such device was successfully implanted in 10 patients considered unfit for transplantation due to severe wall calcification. Two of them have been successfully transplanted with excellent outcomes after 13 and 3 months of follow-up. EndoPreKiT device may be a significant breakthrough in transplant surgery, that could expand the horizon of eligibility to include even the most fragile patients with challenging arterial access.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13486/fullatherosclerosisgraft survivalkidney transplantationvascular calcificationvascular surgical proceduresiliac endoprothesis |
| spellingShingle | Matthieu Arsicot Matthieu Arsicot Raffaele Pio Ammollo Marine Bordet Marine Bordet Leila Dehina-Khenniche Olivier Thaunat Nellie Della Schiava Nellie Della Schiava Antoine Millon Emilien Seizilles De Mazancourt Lionel Badet Xavier Matillon Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification Transplant International atherosclerosis graft survival kidney transplantation vascular calcification vascular surgical procedures iliac endoprothesis |
| title | Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification |
| title_full | Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification |
| title_fullStr | Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification |
| title_full_unstemmed | Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification |
| title_short | Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification |
| title_sort | endovascular preparation with innovative custom made stent graft before kidney transplantation the solution for patients with hostile iliac calcification |
| topic | atherosclerosis graft survival kidney transplantation vascular calcification vascular surgical procedures iliac endoprothesis |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13486/full |
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