Evar surveillance

OBJECTIVE: It is estimated that 22 - 57% of vascular patients are lost to follow-up which is of concern as the Society of Vascular Surgery recommends annual patient follow-up. The purpose of this report was to identify social determinants of health factors (SDoH) and their relationship to loss to follow-up in vascular patients. METHODS: The methods employed were a systematic literature review of 29 empirical articles and a retrospective quality improvement report with 27 endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) patients at the University of Chicago...

OBJECTIVE: This study aimed to report the long-term outcomes beyond 10 years of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) using the low-profile INCRAFT device. METHODS: This was a single-center, retrospective cohort study of all patients undergoing EVAR using the INCRAFT device as part of the regulatory trial between 2012 and 2013. Primary endpoint was aneurysm-related death. Secondary endpoints were all-cause death, reintervention, late open conversion, and aneurysm status (shrinkage, stable, and growth)...

INTRODUCTION: Ruptured abdominal aortic aneurysms (AAA) presenting with hostile neck anatomy can represent a challenge in surgical decision-making. We hypothesized that, patients who require reinterventions have higher rates of compromised neck anatomy at initial presentation and may indicate a need for altered surveillance paradigm. METHODS: Patients presenting with ruptured AAA to a single tertiary care institution from 2014 to 2021 were retrospectively reviewed...

INTRODUCTION: The Society for Vascular Surgery guidelines recommend annual imaging surveillance following endovascular aneurysm repair (EVAR) and every five years following open surgical repairs (OSR) of abdominal aortic aneurysms (AAA). Adherence to these guidelines is low outside of clinical trials and compliance at Veterans Affairs (VA) hospitals is not yet well established. We examined imaging follow-up compliance and mortality rates after AAA repair at VA hospitals. METHODS: We queried the VA Surgical Quality Improvement Program (VASQIP) database for elective infrarenal AAA repairs, EVAR and OSR, then merged in follow-up imaging and mortality information...

PURPOSE: To assess the diagnostic accuracy of BMI-adapted, low-radiation and low-iodine dose, dual-source aortic CT for endoleak detection in non-obese and obese patients following endovascular aortic repair. METHODS: In this prospective single-center study, patients referred for follow-up CT after endovascular repair with a history of at least one standard triphasic (native, arterial and delayed phase) routine CT protocol were enrolled. Patients were divided into two groups and allocated to a BMI-adapted (group A, BMI < 30 kg/m2 ; group B, BMI ≥ 30 kg/m2 ) double low-dose CT (DLCT) protocol comprising single-energy arterial and dual-energy delayed phase series with virtual non-contrast (VNC) reconstructions...

AIMS: Endoleaks are the most common complication after EVAR. CTA is presently the golden standard for lifelong surveillance after EVAR. Several studies and meta-analyses have shown contrast-enhanced Ultrasound (CEUS) to be a good alternative. The main goal of our study was to further validate the inclusion of CEUS in follow-up examination protocols for the systematic surveillance after EVAR. MATERIAL AND METHODS: A retrospective analysis of patients who had received CEUS as part of their routine surveillance after EVAR at our centre was conducted...

BACKGROUND AND AIMS: Abdominal aortic aneurysm(AAA) patients undergo uniform surveillance programs both leading up to, and following surgery. Circulating biomarkers could play a pivotal role in individualizing surveillance. We applied a multi-omics approach to identify relevant biomarkers and gain pathophysiological insights. MATERIALS AND METHODS: In this cross-sectional study, 108 AAA patients and 200 post-endovascular aneurysm repair(post-EVAR) patients were separately investigated...

BACKGROUND: Endoleaks represent the most common complication after EVAR. Some types are associated with ongoing risk of aneurysm rupture and necessitate long-term surveillance and secondary interventions. PURPOSE: This document, as with all CIRSE Standards of Practice documents, will recommend a reasonable approach to best practices of managing endoleaks. This will include imaging diagnosis, surveillance, indications for intervention, endovascular treatments and their outcomes...

There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. The aim of the present review is to collect all the available evidence on the role of abdominal aortic aneurysm (AAA) volume in the natural history of AAAs, including small untreated AAAs and AAAs treated by EVAR. The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR...

OBJECTIVE: The high frequency of reinterventions after Fenestrated Endovascular Aortic Repair (FEVAR) with Physician Modified Endografts (PMEGs) has been well-studied. However, the impact of prior EVAR on reinterventions and sac behavior following these procedures remains unknown. We analyzed 3-year rates of reinterventions and sac dynamics following PMEG for index aneurysm repair compared with PMEG for prior EVAR with loss of proximal seal. METHODS: We performed a retrospective analysis of 122 consecutive FEVARs with PMEGs at a tertiary care center submitted to the FDA in support of an Investigational Device Exemption trial...

Abdominal aortic aneurysms (AAAs) are a significant cause of mortality in developed countries. Endovascular aneurysm repair (EVAR) is currently the leading treatment method for AAAs. Due to the high sensitivity and specificity of post-EVAR complication detection, CT angiography (CTA) is the reference method for imaging surveillance in patients after EVAR. Many studies have shown the advantages of dual-energy CT (DECT) over standard polyenergetic CTA in vascular applications. In this article, the authors briefly discuss the technical principles and summarize the current body of literature regarding dual-energy computed tomography angiography (DECTA) in patients after EVAR...

PURPOSE: Our objective was to investigate whether patients who receive anticoagulation therapy have different outcomes after endovascular aneurysm repair (EVAR) from those who do not. MATERIALS AND METHODS: We conducted a systematic review of studies that compared outcomes of EVAR in patients who were on therapeutic anticoagulation vs those who were not. We developed and reported the review in accordance with the PRISMA guidelines with a registered protocol (CRD42022375894)...

OBJECTIVE: This study aimed to assess aneurysm sac dynamics and its prognostic significance following fenestrated and branched endovascular aneurysm repair (F/BEVAR). METHODS: Patients undergoing F/BEVAR for degenerative complex aortic aneurysm from 2008 to 2020 at two large vascular centres with two imaging examinations (30 day and 1 year) were included. Patients were categorised as regression and non-regression, determined by the proportional volume change (> 5%) at 1 year compared with 30 days...

OBJECTIVE: This study aimed to investigate the correlation between aneurysm sac behaviour and time to re-intervention after endovascular aneurysm repair (EVAR). METHODS: A retrospective observational cohort study of patients who underwent EVAR at a single centre between January 2008 and November 2011 and who were followed up for a mean of 6.6 ± 2.9 years was conducted. Based on sac appearances on pre-operative imaging and imaging at the end of follow up, patients were stratified into two groups: (1) sac regression; and (2) no sac regression...

INTRODUCTION: Abdominal aortic aneurysm (AAA), often characterized by an abdominal aortic diameter over 3.0 cm, is managed through screening, surveillance, and surgical intervention. AAA growth can be heterogeneous and rupture carries a high mortality rate, with size and certain risk factors influencing rupture risk. Research is ongoing to accurately predict individual AAA growth rates for personalized management. Machine learning, a subset of artificial intelligence, has shown promise in various medical fields, including endoleak detection post-EVAR...

This study aimed to investigate the relationship between maximum transverse diameter (MTD) and volume measurements in patients who underwent reoperations after endovascular aneurysm repair (EVAR), and their association with the occurrence of endoleaks. The study included 51 patients who underwent EVAR and subsequent re-operations caused by endoleaks type I-III. In some number of events, multiple re-operations were needed. MTD was measured using the Horos software, and segmentations of the AAA were performed using 3D Slicer...

OBJECTIVE: To evaluate the clinical performance of endovascular aneurysm sealing (EVAS, Endologix Inc. Nellix, Irvine, CA, USA) in treatment of abdominal aortic aneurysm (AAA) at long term follow up. METHODS: Observational, prospective, single centre study of primary AAA interventions with EVAS (n = 117) from November 2013 to November 2016. Endpoints were primary technical success, Nellix device failure, freedom from open surgical conversion (OSC), freedom from secondary intervention, sac rupture, total mortality, and aneurysm related mortality at long term follow up...

INTRODUCTION: Surveillance after endovascular aneurysm repair (EVAR) is traditionally done with computed tomography angiography (CTA) scans that exposes patient to radiation, nephrotoxic contrast media, and potentially increased risk for cancer. Ultrasound (US) is less labor intensive and expensive and might thus provide a good alternative for CTA surveillance. The aim of this study was to evaluate in real-life patient cohorts whether US is able to detect post-EVAR aneurysm-related complications similarly to CTA...

BACKGROUND: Limb occlusion is a potentially serious consequence of endovascular abdominal aortic aneurysm (EVAR). This case-control study identifies factors that predispose to limb occlusion. METHODS: A consecutive series of patients from two centres undergoing EVAR over an eleven-year period 2007- 2017 were identified retrospectively. Patient records were interrogated allowing collations of demographics, intra- and peri-operative data and surveillance data. The pre-operative computed tomography (CT) angiogram was analysed to determine EVAR relevant anatomical data...

OBJECTIVE: To investigate the association between the imaging biomarker (volumetric perivascular characterization index [VPCI]) which indicates the aortic wall inflammation by mapping the spatial changes of perivascular fat attenuation on computed tomography angiography (CTA) and the reintervention risk for abdominal aortic aneurysm (AAA) patients after endovascular aortic repair (EVAR). METHODS: This case-control study included AAA patients undergoing EVAR from a single center (n=260)...