Review of the GORE^Ⓡ VIABAHN^Ⓡ Endoprosthesis with a Heparin Bioactive Surface

Abstract

Hemorrhage occurs in a reported 4％ to 16％ of patients following pancreaticoduodenectomy (PD), most often caused by local infection or vascular erosion secondary to leakage of pancreatic juice or bile from insufficiently secure anastomoses. Surgical exploration is less commonly selected for treatment, because the presence of adhesions and increased tissue friability after surgery would make it technically challenging. Endovascular coil embolization of the affected artery is currently considered as one of the most effective techniques for treating visceral arterial bleeding. However, the liver has many potential collateral pathways that communicate with the adjacent arterial system, and a sudden complete blockage of the hepatic arterial flow immediately after surgery may induce an ischemic insult of the liver parenchyma. An ideal solution to address this dilemma is placement of a stent graft, which would allow complete hemostasis to be achieved while preserving the hepatic arterial flow. In Japan, the GORE^Ⓡ VIABAHN^Ⓡ Endoprosthesis with a Heparin Bioactive Surface was the first stent to gain approval from the PMDA on February 15, 2016．In this lecture, we will present an overview of the VIABAHN ^Ⓡ stent graft, along with a discussion of our own experience of the use of this stent device in the context of the history of endovascular therapy for post-PD complications.