CONFERENCE COVERAGE: Effectiveness of VORTEC Revascularization Shown

November 19, 2009—At the VEITH Symposium in New York City, Mario Lachat, MD, described the nonsutured, Viabahn-based (W. L. Gore & Associates, Flagstaff, AZ) VORTEC (Viabahn Open Revascularization Technique) procedure. The VORTEC procedure is used for revascularization of the left common carotid artery and for performing an antegrade endograft implantation from the ascending aorta, distal to the origin of the feeding graft for debranching, to the descending aorta in one procedure.

Dr. Lachat also provided results from an 8-year experience of using this method to revascularize branches, especially those in anatomically challenging situations. The benefit of this procedure is that few stitches are used, and blood flow is rapidly restored after stent graft deployment. Since 2002, five surgeons have used the VORTEC technique for revascularization of 246 aortic branches. The technical success, 30-day patency, and long-term patency rates for this procedure are excellent: 100%, 94%, and 91%, respectively, Dr. Lachat reported.

This less-invasive prosthetic graft anastomotic technique uses self-expanding stent grafts that are “telescoped” into aortic branches. VORTEC obviates the need for potentially difficult complete vessel exposure and graft anastomoses, thereby reducing the duration of flow interruption and simplifying the performance of complex aortic reconstructions and so-called debranching procedures requiring reconstruction of major branches such as renal arteries.

In the Journal of Vascular Surgery, Dr. Lachat, et al published their experience using the VORTEC procedure to successfully treat a floating thrombus that extended throughout the whole aortic arch and involved all of the supra-aortic trunks by debranching the supra-aortic trunks and implanting an antegrade endograft (2009;50:1117–1180).