INDICATIONS, SAFETY, AND WARNINGS Valiant™ Thoracic Stent Graft with the Captivia™ Delivery System

Indications

The Valiant™ Thoracic Stent Graft with the Captivia™ Delivery System is indicated for the endovascular repair of all lesions of the descending thoracic aorta (DTA) in patients having appropriate anatomy, including:

  • iliac/femoral artery access vessel morphology that is compatible with vascular access techniques, devices, or accessories;
  • nonaneurysmal aortic diameter in the range of 18 mm to 42mm (fusiform and saccular aneurysms/penetrating ulcers), 18 mm to 44 mm (blunt traumatic aortic injuries), or 20 mm to 44 mm (dissections); and
  • nonaneurysmal aortic proximal and distal neck lengths ≥ 20mm (fusiform and saccular aneurysms/penetrating ulcers), landing zone ≥20 mm proximal to the primary entry tear (blunt traumatic aortic injuries, dissections). The proximal extent of the landing zone must not be dissected.

Contraindications

The Valiant thoracic stent graft with the Captivia delivery system is contraindicated in:

  • Patients who have a condition that threatens to infect the graft.
  • Patients with known sensitivities or allergies to the device materials.

Warnings and Precautions

The long-term safety and effectiveness of the Valiant thoracic stent graft with the Captivia delivery system has not been established. All patients should be advised that endovascular treatment requires lifelong, regular follow-up to assess the integrity and performance of the implanted endovascular stent graft. Patients with specific clinical findings (for example, enlarging aneurysm (> 5 mm), endoleaks, migration, inadequate seal zone, or continued flow into the false lumen in the case of a dissection) should receive enhanced follow-up. Specific follow-up guidelines are described in the Instructions for Use. The Valiant thoracic stent graft with the Captivia delivery system is not recommended in patients who cannot undergo, or who will not be compliant with, the necessary preoperative and post-operative imaging and implantation procedures as described in the Instructions for Use. Strict adherence to the Valiant thoracic stent graft sizing guidelines as described in the Instructions for Use is expected when selecting the device size. Sizing outside of this range can potentially result in endoleak, fracture, migration, infolding, or graft wear. As cautioned in the Instructions for Use, a balloon should never be used when treating a dissection. The safety and effectiveness of the Valiant thoracic stent graft with the Captivia delivery system has not been evaluated in some patient populations. Please refer to the product Instructions for Use for details.

MRI Safety and Compatibility 

Non-clinical testing has demonstrated that the Valiant thoracic stent graft is MR-conditional. It can be scanned safely in both 1.5T and 3.0T MR systems under specific conditions as described in the product Instructions for Use. For additional information regarding MRI, please refer to the product Instructions for Use.

Adverse Events

Potential adverse events include, but are not limited to, access failure, access site complications (e.g., spasm, trauma, bleeding, rupture, dissection), adynamic ileus, allergic reaction (to contrast, antiplatelet therapy, stent graft material), amputation, anaesthetic complications, aortic expansion (e.g., aneurysm, false lumen), aneurysm rupture, angina, arrhythmia, arterial stenosis, atelectasis, blindness, bowel ischemia/infarction, bowel necrosis, bowel obstruction, branch vessel occlusion, buttock claudication, cardiac tamponade, catheter breakage, cerebrovascular accident (CVA)/stroke, change in mental status, coagulopathy, congestive heart failure, contrast toxicity, conversion to surgical repair, death, deployment difficulties/failures, dissection/perforation/rupture of the aortic vessel and/or surrounding vasculature, embolism, endoleak(s), excessive or inappropriate radiation exposure, extrusion/erosion, failure to deliver stent graft, femoral neuropathy, fistula (including aortobronchial, aortoenteric, aortoesophageal, arteriovenous, and lymph), gastrointestinal bleeding/complications, genitourinary complications, hematoma, hemorrhage/bleeding, hypotension/hypertension, infection or fever, insertion or removal difficulties, intercostal pain, intramural hematoma, leg/foot edema, lymphocele, myocardial infarction, neuropathy, occlusion — venous or arterial, pain/reaction at catheter insertion site, paralysis, paraparesis, paraplegia, paresthesia, perfusion of the false lumen, peripheral ischemia, peripheral nerve injury, pneumonia, post-implant syndrome, procedural/post-procedural bleeding, prosthesis dilatation/infection/rupture/thrombosis, pseudoaneurysm, pulmonary edema, pulmonary embolism, reaction to anaesthesia, renal failure, renal insufficiency, reoperation, respiratory depression/failure, sepsis, seroma, shock, spinal neurological deficit, stent graft material failure (including breakage of metal portion of device)/migration/misplacement/occlusion/twisting/kinking, transient ischemic attack (TIA), thrombosis, tissue necrosis, vascular ischemia, vascular trauma, wound dehiscence, wound healing complications, wound infection.

Please reference product Instructions for Use for more information regarding indications, warnings, precautions, contraindications, and adverse events.

Caution: Federal (USA) law restricts this device to sale by or on the order of a physician.