ASVS 2022

Kiattisak Hongku

Nationality

Thailand

Current Position

Instructor

Organization

Division of Vascular Surgery, Siriraj Hospital, Mahidol University, Thailand

Thoracic Aorta (II) SessionSunday, Oct. 23, 2022 10:30-12:00 @Ballroom I

Topic: Totally endovascular treatment of TAAA using a physician-modified thoracic endograft for treatment of TAAA

Abstract

Endovascular repair has become an established and standardized treatment of TAAA. Fenestration and branched endograft are the configurations of choice for target vessel incorporation available in both custom-made (CMD) and off-the-shelf (OTS) devices. Ideally, CMD is device of choice if available, however the manufacturing turn-around period is its major drawback. The OTS devices are developed to address this constraint, but they are also limited by anatomical suitability and availability of devices. Physician-modified endograft (PMEG) is an alternative off-the-shelf option constructed on the well-established principle of endograft branching with fenestration or branch cuffs. This is significantly valuable in the urgent situations where the CMD is not readily available, and the OTS device is also unavailable or anatomically unsuitable. The outcomes of PMEGs have been demonstrated in all aortic territories, especially for juxtarenal AAA where positive outcomes from IDE trials were promising. Despite of those encouraging results, the lack of standardized configurations and long-term durability of the modified endograft are concerned. New technologies such as 3D printing and automated software are designed and introduced to facilitate PMEG construction, but they are still subjected to forementioned limitations. Case selection and operators’ experiences are among the important factors affecting the outcomes of this kind of procedure.

Session

Topic:

Abstract

Education

-Doctor of Medicine (2002; Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand)
-Thai Board of General Surgery (2009; Siriraj Hospital, Thailand)
-Thai Board of Vascular Surgery (2011 Siriraj Hospital, Thailand)
-Advanced Aortic and Peripheral Endovascular Surgery Fellowship
(2014-2015; Division of Vascular Surgery, McGill University, Quebec, Canada)
-Clinical and research training program in endovascular surgery (2015-2017; Vascular Center, Department of Thoracic and Vascular Disease, Skåne University Hospital, Malmö, Sweden)

Research Experience

Honors/Awards

Selected Publications

Hongku K, Resch T, Sonesson B, Kristmundsson T, Dias NV. Applicability and midterm results of branch cuff closure with vascular plug in branched endovascular repair for thoracoabdominal aortic aneurysms. J Vasc Surg. 2017 Aug;66(2):367-374
Hongku K, Sonesson B, Björses K, Holst J, Resch T, Dias NV. Mid-term Outcomes of Endovascular Repair of Ruptured Thoraco-abdominal Aortic Aneurysms with Off the Shelf Branched Stent Grafts. Eur J Vasc Endovasc Surg 2018 Mar;55(3):377-384
Hongku K, Resch T, Sonesson B, Dias NV. The Midterm Results of Fenestrated and Branched Aneurysm Repair of Previous Failed Fenestrated EVAR. Ann Vasc Surg. 2020 Aug;67:35-42.e1. doi: 10.1016/j.avsg.2020.02.018. Epub 2020 Mar 23. PMID: 32217138
Charbonneau P, Hongku K, Herman CR, Habib M, Girsowicz E, Doonan RJ, Dubois L, Hossain S, Gill HL, Mackenzie KS, Bayne JP, Obrand D, Steinmetz OK. Long-term survival after endovascular and open repair in patients with anatomy outside instructions for use criteria for endovascular aneurysm repair. J Vasc Surg. 2019 Dec;70(6):1823-1830. doi: 10.1016/j.jvs.2019.01.081. Epub 2019 May 21. Erratum in: J Vasc Surg. 2020 Jun;71(6):2189. PMID: 31126766

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