Contato | Braile Biomédica

Patient´s name (initials):

Birth date:

Procedure date:

Sex:

Doctor:

Proctor:

Technical support:

Hospital:

City:

State:

Country:

Medical agreement:

Distributor/Representative:

Stent-Graft Linus:

Monoiliac
Forked

Stent-Graft Dominus:

Straight
Fenestration
Conical
Custom

Other Models of Endoprosthesis

Iliac extension
Aorto-iliac
Occluder
Lumini

Diagnosis:

Coarctation
Dissection
Thoracic aortic aneurysm
Thoracoabdominal aneurysm
Abdominal aortic aneurysm
Aorto-iliac aneurysm
Broken aneurysm
Other, describe

Diagnosis:

Describe:

Type of surgery:

Elective
Urgency

Post-release balancing:

Yes
No

Type of implant:

First
Replenishment

Number of previous implants:

Procedure outcome:

Success
Complications
Procedure interrupted, reason:

Reason:

Endoleak:

Tipo Ia - proximal
Tipo Ib - distal
Type II - collateral
Type III - complications related to the connection
Type IV - effect of heparin

Describe:

Braile Biomédica

Implant Registration - Stent-Graft Endoprostheses

Implant Registration - Stent-Graft Endoprostheses

Stent-Graft Linus:

Stent-Graft Dominus:

Other Models of Endoprosthesis

Diagnosis:

Diagnosis:

Type of surgery:

Post-release balancing:

Type of implant:

Number of previous implants:

Procedure outcome:

Reason:

Endoleak:

Complications related to device:

Describe:

Complications Related to Clinical Aspects:

Describe: