Troubleshooting Techniques - Medtronic Valiant Navion Gebrauchsanweisung

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1. Proximal RO marker
2. RO mid-marker
3. Minimum required overlap
4. Distal RO marker
9.12. Angiogram
Upon completing the implant procedure, perform angiography to verify stent graft apposition, seal, and any endoleaks at the
proximal and distal ends of the stent graft. Assess the stent graft for mid-graft and graft junction endoleaks.
Perform adjunctive maneuvers as needed, such as ballooning or insertion of additional devices. The most reliable course of
endoleak management (Type I or Type III) is remodeling the stent graft with a balloon and, if needed, placing an additional
stent graft (Section 9.10 and Section 9.11). A minor leak that does not seal after reballooning may seal spontaneously within
several days. If any adjunctive maneuvers are conducted, perform a final angiogram to confirm successful exclusion of the
lesion.
Caution: Do not use a balloon catheter to treat aortic dissection.
Caution: High pressure injections at the edges of the Valiant Navion thoracic stent graft immediately after implantation may
cause acute endoleaks.
Caution: Any endoleak left untreated during the implantation procedure must be carefully monitored after implantation.
9.13. Entry site closure
Remove all remaining accessories (for example, guidewire, introducer sheath, or angiogram catheter). Close the arteriotomy
site by standard surgical closure techniques.

10. Troubleshooting techniques

In the unlikely event of delivery system failure, the following bail-out techniques may be used.
10.1. Partial stent graft deployment
If partial stent graft deployment due to graft cover severance occurs, a screw gear handle disassembly technique may permit
successful deployment of the stent graft.
1. Use a scalpel or other sharp cutting tool to cut the front grip.
2. Slice the gray front grip along one of the grooves (Figure 14). Use caution to avoid cutting the strain relief and the graft
cover tubing underneath the front grip.
24 Instructions for Use
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Figure 13. Alignment of additional sections (first graft placed distally)
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