ArticleEJVES vascular forum2026
Alto Deployment in Patients With Severe Tortuosity of the Proximal Aorta: An
Article in EJVES vascular forum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Innovation with a Footnote: A Rare Limitation in an Otherwise Promising Endograft.EJVES vascular forum · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: The Alto stent graft system accommodates various anatomies but presents unique challenges. In Japan, polymer filling failures occurred in 1.1% of cases, prompting an investigation into potential causes. It was hypothesised that polymer port location and proximal neck angulation contribute to these failures. The Alto device limits the suprarenal angle to <60° but does not specify the infrarenal neck angle. Because a 90° infrarenal angle is off label for many devices, the infrarenal angle was set at 90° for this study. The aim of this study was to identify the optimal port position for severe proximal aortic tortuosity and to determine the appropriate timing for stiff guidewire withdrawal. Report: An Discussion: For the Alto system, aligning the polymer port with the greater curvature of the proximal aortic neck and straightening the aorta with an extra stiff guidewire in cases of severe tortuosity (approximately 90°) are key to ensuring complete polymer filling and preventing failure.
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