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https://www.readbyqxmd.com/read/28073666/standard-endovascular-aneurysm-repair-in-patients-with-wide-infrarenal-aneurysm-necks-is-associated-with-increased-risk-of-adverse-events
#1
Nelson F G Oliveira, Frederico M Bastos Gonçalves, Marie Josee Van Rijn, Quirina de Ruiter, Sanne Hoeks, Jean-Paul P M de Vries, Joost A van Herwaarden, Hence J M Verhagen
OBJECTIVE: Endovascular aneurysm repair (EVAR) has progressively expanded to treat more challenging anatomies. Although EVAR in patients with wide infrarenal necks has been reported with acceptable results, there is still controversy regarding the longer-term outcomes. Our aim is to determine the impact of infrarenal neck diameter on midterm outcome following EVAR with a single endograft with suprarenal fixation. METHODS: A retrospective case-control study was designed using data from a prospective multicenter database...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28051289/failure-modes-and-secondary-endovascular-interventions-after-endovascular-aortic-repair
#2
Timothy Resch
Endovascular repair has a firmly established role in the treatment of aortic disease. The development of endovascular devices to treat even complex aortic disease has broadened the panorama of repair significantly but has also introduced new forms of repair failure. Standard devices for EVAR and TEVAR have also been enhanced, providing better adaptation to the anatomy treated, smaller delivery systems, more intuitive delivery designs as well as improved features to facilitate precise delivery of the device...
January 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28031671/endovascular-management-of-type-i-endoleak-with-fenestrated-aortic-cuff-and-afterwards-treatment-of-endoleak-type-iii
#3
Stevo Duvnjak
Endovascular aortic repair (EVAR) has become preferable treatment of abdominal aortic aneurysms because of proven mortality reduction as well as complications reduction compared with open surgery. Endoleak remains a primary complication of EVAR, however, and occurs in 20 to 25% of the patients. EVAR patients thus undergo lifelong surveillance for the presence of aneurysm expansion and endoleaks usually via computed tomographic angiography. We describe the endovascular management of an enlarged aneurysmal sac size 3 years after EVAR due to combined endoleak of types 1 and 3...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28027890/iliac-seal-zone-dynamics-and-clinical-consequences-after-endovascular-aneurysm-repair
#4
F Bastos Gonçalves, N F Oliveira, M Josee van Rijn, K H J Ultee, S E Hoeks, S Ten Raa, R J Stolker, H J M Verhagen
OBJECTIVE: To evaluate the dynamics of the iliac attachment zone after EVAR, and the association with clinical events. METHODS: A tertiary institution's prospective EVAR database was searched to identify common iliac arteries at risk. Internally validated measurements were made, using centre lumen line reconstructions. Iliac dilatation and endograft limb retraction were the main endpoints. Associations between dilatation, retraction, oversizing, and distal seal length were investigated...
February 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28017805/management-of-immediate-post-endovascular-aortic-aneurysm-repair-type-ia-endoleaks-and-late-outcomes
#5
Ali F AbuRahma, Stephen M Hass, Zachary T AbuRahma, Michael Yacoub, Albeir Y Mousa, Shadi Abu-Halimah, L Scott Dean, Patrick A Stone
BACKGROUND: Post endovascular aortic aneurysm repair (EVAR) endoleaks and the need for reintervention are challenging. Additional endovascular treatment is advised for Type Ia endoleaks detected on post-EVAR completion angiogram. This study analyzes management and late outcome of these endoleaks. PATIENT POPULATION AND METHODS: This is a retrospective review of prospectively collected date of EVAR patients during a 10-year period. All post-EVAR Type Ia endoleaks on completion angiogram were identified (Group A) and their early (30-day) and late outcomes were compared to patients without endoleaks (Group B)...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28017583/three-dimensional-contrast-enhanced-ultrasound-improves-endoleak-detection-and-classification-after-endovascular-aneurysm-repair
#6
Christopher Lowe, Abeera Abbas, Steven Rogers, Lee Smith, Jonathan Ghosh, Charles McCollum
BACKGROUND: Three-dimensional contrast-enhanced ultrasound (3D-CEUS) is a novel technology allowing surgeons to view duplex ultrasound images in three dimensions with ultrasound contrast highlighting blood flow in endoleaks after endovascular aneurysm repair (EVAR). It potentially reduces the need for computed tomography angiography (CTA) and catheter angiography. This study compares 3D-CEUS with both CTA and the final vascular multidisciplinary team (MDT) diagnosis using all available imaging...
December 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27974495/a-systematic-review-of-proximal-neck-dilatation-after-endovascular-repair-for-abdominal-aortic-aneurysm
#7
George N Kouvelos, Kyriakos Oikonomou, George A Antoniou, Eric L G Verhoeven, Athanasios Katsargyris
PURPOSE: To provide an updated systematic literature review and summarize current evidence on proximal aortic neck dilatation (AND) after endovascular aneurysm repair (EVAR). METHODS: A review of the English-language medical literature from 1991 to 2015 was conducted using MEDLINE and EMBASE to identify studies reporting AND after EVAR. Studies considered for inclusion and full-text review fulfilled the following criteria: (1) reported AND after EVAR, (2) included at least 5 patients, and (3) provided data on AND quantification...
February 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27965719/what-is-the-role-of-contrast-enhanced-ultrasound-in-the-evaluation-of-the-endoleak-of-aortic-endoprostheses-a-comparison-between-ceus-and-ct-on-a-widespread-scale
#8
COMPARATIVE STUDY
E David, V Cantisani, H Grazhdani, L Di Marzo, L Venturini, F Fanelli, M Di Segni, N Di Leo, L Brunese, F Calliada, M Ciccariello, A Bottari, G Ascenti, F D'Ambrosio
OBJECTIVE: To evaluate the accuracy of contrast-enhanced ultrasound (CEUS) in comparison to CT angiography (CTA) to identify and classify endoleaks following abdominal aortic aneurism repair with endoprosthesis. MATERIALS AND METHODS: A retrospective analysis of 181 patients treated with EVAR, from September 2009 to September 2014, was performed. Patients were evaluated with CEUS, CTA and angiography in the cases requiring treatment. Sac diameter, sac integrity, identification and classification of endoleaks were taken into consideration...
December 2016: Journal of Ultrasound
https://www.readbyqxmd.com/read/27903482/systematic-review-and-meta-analysis-of-preoperative-risk-factors-of-type-ii-endoleaks-after-endovascular-aneurysm-repair
#9
REVIEW
Florent Lalys, Vincent Durrmann, Aurélien Duménil, Cemil Göksu, Alain Cardon, Elodie Clochard, Antoine Lucas, Adrien Kaladji
BACKGROUND: Type II endoleaks (T2Es) remain the Achilles heel of endovascular aneurysm repair (EVAR), involving a close follow-up and sometimes leading to reintervention. Identifying risk factors impacting T2Es is of concern to improve decision making and optimize follow-up. However, it has led to contradictory results, with supporting evidence for the majority of factors being weak. METHODS: A systematic review and meta-analysis was conducted to study risk factors of T2Es following EVAR to identify risk factors and measure their dedicated strength of association...
November 27, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27884710/predisposing-factors-for-re-interventions-with-additional-iliac-stent-grafts-after-endovascular-aortic-repair
#10
H Roos, C Sandström, G Koutouzi, A Jeppsson, M Falkenberg
BACKGROUND: Endoleaks of type Ib and III are relatively common causes of re-intervention after EVAR. The aim was to determine underlying causes and identify anatomical factors associated with these re-interventions. METHODS: A total of 444 patients with standard bifurcated stent grafts were included in a retrospective observational study. Patients requiring additional iliac stent grafts (n = 24) were compared to those who did not (n = 420). Pre- and post-operative CT examinations were reviewed in patients with additional iliac stents...
January 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27879950/systematic-review-of-follow-up-compliance-after-endovascular-abdominal-aortic-aneurysm-repair
#11
Konstantinos Spanos, Christos Karathanos, Athanasios Athanasoulas, Vasileios Sapeltsis, Athanasios D Giannoukas
BACKGROUND: Lifelong surveillance after Endovascular Aortic Aneurysm repair (EVAR) is recommended to monitor the effectiveness and durability of the treatment. The aim of this study was to assess patients' compliance with the follow-up imaging protocol, the presence of any factors associated with compliance and the potential influence of imaging-protocol adherence on outcomes. EVIDENCE ACQUISITION: MEDLINE, CENTRAL, and Cochrane databases and keys references were searched...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27871492/the-natural-history-of-type-ii-endoleaks-after-endovascular-aneurysm-repair-for-ruptured-abdominal-aortic-aneurysm
#12
Anna E Boniakowski, Randall R De Martino, Dawn M Coleman, Jonathan L Eliason, Phillip P Goodney, John E Rectenwald
OBJECTIVE: The natural history of type II endoleak (T2EL) after endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) remains elusive; as such, treatment guidelines are ill defined. The purpose of this study was to better delineate the natural history of T2EL after EVAR for rAAA in an effort to determine the need for reintervention and optimal surveillance. METHODS: A retrospective record review was conducted of all patients undergoing EVAR for rAAA in two large tertiary care academic vascular centers...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27857945/abdominal-aortic-aneurysm-type-ii-endoleaks
#13
Mohamed S Kuziez, Luis A Sanchez, Mohamed A Zayed
Type II endoleaks occur commonly following endovascular aneurysm repair (EVAR). Although they remain enigmatic, multiples studies have evaluated preoperative risk factors and strategies for prevention of type II endoleaks. Prophylactic treatment of type II endoleaks can include embolization of accessory arteries, as well as complete aneurysmal sac occlusion. Regular post-operative surveillance and screening for type II endoleaks with triple-phase CTA is the standard of care. Aneurysm size and growth rate are factors that predict whether a persistence type II endoleak is hemodynamically significant, and whether it requires treatment with percutaneous trans-lumbar or trans-arterial embolization techniques...
September 2016: Journal of Cardiovascular Diseases & Diagnosis
https://www.readbyqxmd.com/read/27823589/intervention-after-endovascular-aneurysm-repair-endosalvage-techniques-including-perigraft-arterial-sac-embolization-and-endograft-relining
#14
REVIEW
Andrew Barleben, Tazo Inui, Erik Owens, John S Lane, Dennis F Bandyk
Endovascular aneurysm repair (EVAR) has revolutionized the treatment of abdominal aortic aneurysm (AAA). However, persistent AAA sac endoleak following EVAR can result in sac diameter increase requiring re-intervention in up to one-third of cases and even result in aneurysm rupture. In this case review, we summarize and detail endovascular re-interventions for each type of endoleak. We also detail specific options including stent-graft relining for indeterminate, Type III, and Type IV endoleaks and perigraft arterial sac embolization to induce thrombosis and resolve acute Type I, II, or III endoleaks...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27760698/contrast-enhanced-ultrasound-can-replace-computed-tomography-angiography-for-surveillance-after-endovascular-aortic-aneurysm-repair
#15
K K Bredahl, M Taudorf, L Lönn, K C Vogt, H Sillesen, J P Eiberg
OBJECTIVE/BACKGROUND: Surveillance after endovascular aortic aneurysm repair (EVAR) is mandatory and computed tomography angiography (CTA) is considered the standard imaging modality, although patients are exposed to ionizing radiation and nephrotoxic contrast medium. The primary aim of this study was to determine the diagnostic efficacy of duplex ultrasound (DUS) and contrast enhanced ultrasound (CEUS) using CTA as the gold standard. The secondary aim was to determine the clinical consequences of endoleaks missed by DUS and CEUS, or CTA...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27743617/endovascular-versus-open-repair-of-abdominal-aortic-aneurysm-in-15-years-follow-up-of-the-uk-endovascular-aneurysm-repair-trial-1-evar-trial-1-a-randomised-controlled-trial
#16
Rajesh Patel, Michael J Sweeting, Janet T Powell, Roger M Greenhalgh
BACKGROUND: Short-term survival benefits of endovascular aneurysm repair (EVAR) versus open repair of intact abdominal aortic aneurysms have been shown in randomised trials, but this early survival benefit is lost after a few years. We investigated whether EVAR had a long-term survival benefit compared with open repair. METHODS: We used data from the EVAR randomised controlled trial (EVAR trial 1), which enrolled 1252 patients from 37 centres in the UK between Sept 1, 1999, and Aug 31, 2004...
October 12, 2016: Lancet
https://www.readbyqxmd.com/read/27699159/bilateral-type-iiia-endoleak-and-disconnection-of-both-limbs-after-evar-with-an-endurant-ii-endograft
#17
Sotirios Giannakakis, George Galyfos, Georgios Geropapas, Stavros Kerasidis, Gerasimos Papacharalampous, Georgios Kastrisios, Chrisostomos Maltezos
A 75-year-old patient with severe comorbidities was treated with an Endurant(®) (Medtronic, USA) II endograft due to a ruptured abdominal aortic aneurysm (AAA). After four years of unremarkable follow-up, bilateral limb separation was detected. The patient underwent endovascular bridging without any complication. Although rarely detected in newer grafts, late bilateral type IIIa endoleaks can present and should be promptly repaired. Complex or ruptured AAAs treated with off-label use of endografts should be under closer surveillance using imaging tools for potential endoleaks or aneurysm sac growth...
September 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27542700/a-systematic-review-of-ultrasound-or-magnetic-resonance-imaging-compared-with-computed-tomography-for-endoleak-detection-and-aneurysm-diameter-measurement-after-endovascular-aneurysm-repair
#18
Qiang Guo, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Guojun Zeng, Fei Xiong, Xiaojiong Du
PURPOSE: To analyze the literature comparing ultrasound [duplex (DUS) or contrast-enhanced (CEUS)] or magnetic resonance imaging (MRI) with computed tomography angiography (CTA) for endoleak detection and aneurysm diameter measurement after endovascular aneurysm repair (EVAR). METHODS: A systematic review identified 31 studies that included 3853 EVAR patients who had paired scans (DUS or CEUS vs CTA or MRI vs CTA) within a 1-month interval for identification of endoleaks during EVAR surveillance...
August 19, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27304848/quality-of-life-symptoms-and-treatment-satisfaction-in-patients-with-aortic-aneurysm-using-new-abdominal-aortic-aneurysm-specific-patient-reported-outcome-measures
#19
G Peach, J Romaine, P J E Holt, M M Thompson, C Bradley, R J Hinchliffe
BACKGROUND: The aim of this study was to present preliminary data on quality of life (QoL), symptoms and treatment satisfaction gathered using three new abdominal aortic aneurysm (AAA)-specific patient-reported outcome measures (PROMs). METHODS: Patients with AAA were recruited from five National Health Service Trusts to complete the three new PROMs: the AneurysmDQoL, AneurysmSRQ and AneurysmTSQ. Patients were either under surveillance or had undergone AAA repair (open or endovascular) during the preceding 24 months...
July 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27303669/contemporary-applications-of-ultrasound-in-abdominal-aortic-aneurysm-management
#20
REVIEW
Mark Scaife, Triantafillos Giannakopoulos, Georges E Al-Khoury, Rabih A Chaer, Efthymios D Avgerinos
Ultrasound (US) is a well-established screening tool for detection of abdominal aortic aneurysms (AAAs) and is currently recommended not only for those with a relevant family history but also for all men and high-risk women older than 65 years of age. The advent of minimally invasive endovascular techniques in the treatment of AAAs [endovascular aneurysm repair (EVAR)] has increased the need for repeat imaging, especially in the postoperative period. Nevertheless, preoperative planning, intraoperative execution, and postoperative surveillance all mandate accurate imaging...
2016: Frontiers in Surgery
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