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Evar surveillance

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https://www.readbyqxmd.com/read/29701395/elective-2nd-stage-tevar-to-complete-frozen-elephant-trunk-in-the-surgical-correction-of-complex-multisegmental-pathology-of-the-thoracic-aorta
#1
Álvaro Laranjeira Santos, António Cruz Tomás, Daniela Varela-Afonso, Jorge Pinheiro Santos, José Fragata
INTRODUCTION: Classical conventional surgery to treat multi-segmental thoracic aortic disease in two operative stages, sternotomy and left thoracotomy, is associated with significant mortality and complications. The Frozen Elephant Trunk (FET) associated with an endovascular procedure (TEVAR) allows an extensible and simplified surgical approach of the descending and thoracoabdominal aorta without increasing the risk. METHODS: Retrospective study of 8 patients (pts), 5 males, mean age 67...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701379/which-aneurysm-characteristics-predict-evar-nonsuccess
#2
Pedro Pinto Sousa, Pedro Brandão, Alexandra Canedo
INTRODUCTION: Hostile anatomic characteristics in patients undergoing endovascular abdominal aortic aneurysm repair (EVAR) may lead to technical nonsuccess of the procedure, late complications, reintervention or death. The authors analyzed anatomical abdominal aortic aneurysm specific considerations so as technical endoprosthesis implantation and correlate them with endoleak development and postoperative survival. METHODS: Authors retrospectively reviewed all consecutive, elective, EVAR's that occurred between 2010 and 2016, with available data, at one institution for abdominal, infra renal, aortic aneurysms...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29673811/endovascular-aortic-repair-follow-up-protocol-based-on-contrast-enhanced-ultrasound-is-safe-and-effective
#3
Emiliano Chisci, Linda Harris, Azzurra Guidotti, Angelica Pecchioli, Clara Pigozzi, Enrico Barbanti, Leonardo Ercolini, Stefano Michelagnoli
OBJECTIVES: The aim of this study was to define the safety and effectiveness of a contrast enhanced ultrasound (CEUS) based follow up for endovascular aortic repair (EVAR) surveillance at a mid-term period (4 years). METHODS: At the tertiary referral centre EVAR surveillance was based on plain abdominal radiograph and duplex ultrasound (CDU), with computed tomography angiography (CTA) reserved for any non-diagnostic imaging during the period 1999-2011 (Group A)...
April 17, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29658769/multimodality-imaging-assessment-of-endoleaks-post-endovascular-aortic-repair
#4
Sasan Partovi, Thomas Trischman, Vasileios Rafailidis, Suvranu Ganguli, Fabian Rengier, Harold Goerne, Prabhakar Rajiah, Daniel Staub, Indravadan J Patel, George Oliveira, Brian Ghoshhajra
Endoleaks are a common complication of endovascular aortic repair (EVAR). As a result, patients require lifelong imaging surveillance following EVAR. In current clinical practice evaluation for endoleaks is predominantly performed with computed tomography angiography (CTA). Due to the significant cumulative radiation burden associated with repetitive CTA imaging, as well as the repeated administration of nephrotoxic contrast agent, contrast-enhanced ultrasound (CEUS) and magnetic resonance angiography (MRA) have evolved as potential modalities for lifelong surveillance post-EVAR...
April 16, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29615450/prospective-single-uk-centre-comparative-study-of-the-predictive-values-of-contrast-enhanced-ultrasound-compared-to-time-resolved-ct-angiography-in-the-detection-and-characterisation-of-endoleaks-in-high-risk-patients-undergoing-endovascular-aneurysm-repair
#5
Iain Nicholas Roy, Tze Yuan Chan, Gabriela Czanner, Steve Wallace, Srinivasa Rao Vallabhaneni
INTRODUCTION: Diagnosis of endoleaks is imperative to prevent failure of endovascular aneurysm repairs (EVARs). The gold standard for diagnosis of endoleaks is catheter-directed subtraction angiography, which is not a practicable choice for surveillance. CT angiography (CTA) is the historical surveillance modality of choice. Concerns over cost, potential nephrotoxicity of contrast agents and repeated radiation exposure led to colour duplex ultrasound scan (CDUS) becoming an established alternative...
April 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29579326/follow-up-after-endovascular-aortic-aneurysm-repair-can-be-stratified-based-on-first-postoperative-imaging
#6
H Baderkhan, O Haller, A Wanhainen, M Björck, K Mani
BACKGROUND: Lifelong postoperative surveillance is recommended following endovascular aneurysm repair (EVAR). Although the purpose is to prevent and/or identify complications early, it also results in increased cost and workload. This study was designed to examine whether it may be possible to identify patients at low risk of complications based on their first postoperative CT angiogram (CTA). METHODS: All patients undergoing EVAR in two Swedish centres between 2001 and 2012 were identified retrospectively and categorized based on the first postoperative CTA as at low risk (proximal and distal sealing zone at least 10 mm and no endoleak) or high risk (sealing zone less than 10 mm and/or presence of any endoleak) of complications...
May 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29532650/late-open-conversion-after-endovascular-abdominal-aortic-repair-a-20-year-experience
#7
Hyun-Chel Joo, Seung-Hyun Lee, Byung-Chul Chang, Sak Lee, Kyung-Jong Yoo, Young-Nam Youn
BACKGROUND: With the increasing use of endovascular aortic repair, secondary interventions after aortic stent grafting remain a concern. We retrospectively reviewed open conversion cases with complications following endovascular abdominal aortic repair (EVAR). METHODS: EVAR due to infra-renal abdominal aortic aneurysm (AAA) was performed in 566 patients between January 1994 and May 2015. A retrospective review of EVAR requiring late open conversion (>1 month after implant) was conducted...
March 12, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29526377/short-term-and-midterm-survival-of-ruptured-abdominal-aortic-aneurysms-in-the-contemporary-endovascular-era
#8
Charles S Briggs, Joshua A Sibille, Halim Yammine, Jocelyn K Ballast, William Anderson, Tzvi Nussbaum, Timothy S Roush, Frank R Arko
OBJECTIVE: Endovascular aneurysm repair (EVAR) has been shown to reduce mortality in the emergent repair of ruptured abdominal aortic aneurysms (AAAs). However, long-term survival data for this group of patients are lacking with contemporary endovascular endografts. The purpose of this study was to evaluate both 30-day mortality rates and 1-year survival in patients undergoing emergent EVAR in a 43-facility hospital system with a quaternary referral center with an established ruptured aneurysm protocol...
March 8, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29503083/editor-s-choice-re-interventions-after-repair-of-ruptured-abdominal-aortic-aneurysm-a-report-from-the-improve-randomised-trial
#9
Janet T Powell, Michael J Sweeting, Pinar Ulug, Matthew M Thompson, Robert J Hinchliffe
OBJECTIVE/BACKGROUND: The aim was to describe the re-interventions after endovascular and open repair of rupture, and investigate whether these were associated with aortic morphology. METHODS: In total, 502 patients from the IMPROVE randomised trial (ISRCTN48334791) with repair of rupture were followed-up for re-interventions for at least 3 years. Pre-operative aortic morphology was assessed in a core laboratory. Re-interventions were described by time (0-90 days, 3 months-3 years) as arterial or laparotomy related, respectively, and ranked for severity by surgeons and patients separately...
May 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29460069/experimental-feasibility-of-spectral-photon-counting-computed-tomography-with-two-contrast-agents-for-the-detection-of-endoleaks-following-endovascular-aortic-repair
#10
Julia Dangelmaier, Daniel Bar-Ness, Heiner Daerr, Daniela Muenzel, Salim Si-Mohamed, Sebastian Ehn, Alexander A Fingerle, Melanie A Kimm, Felix K Kopp, Loic Boussel, Ewald Roessl, Franz Pfeiffer, Ernst J Rummeny, Roland Proksa, Philippe Douek, Peter B Noël
OBJECTIVES: After endovascular aortic repair (EVAR), discrimination of endoleaks and intra-aneurysmatic calcifications within the aneurysm often requires multiphase computed tomography (CT). Spectral photon-counting CT (SPCCT) in combination with a two-contrast agent injection protocol may provide reliable detection of endoleaks with a single CT acquisition. METHODS: To evaluate the feasibility of SPCCT, the stent-lined compartment of an abdominal aortic aneurysm phantom was filled with a mixture of iodine and gadolinium mimicking enhanced blood...
February 19, 2018: European Radiology
https://www.readbyqxmd.com/read/29460048/abdominal-aortic-aneurysms-pre-and-post-procedural-imaging
#11
Richard L Hallett, Brant W Ullery, Dominik Fleischmann
Abdominal aortic aneurysm (AAA) is a relatively common, potentially life-threatening disorder. Rupture of AAA is potentially catastrophic with high mortality. Intervention for AAA is indicated when the aneurysm reaches 5.0-5.5 cm or more, when symptomatic, or when increasing in size > 10 mm/year. AAA can be accurately assessed by cross-sectional imaging including computed tomography angiography and magnetic resonance angiography. Current options for intervention in AAA patients include open surgery and endovascular aneurysm repair (EVAR), with EVAR becoming more prevalent over time...
May 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29430936/tailored-ct-angiography-in-follow-up-after-endovascular-aneurysm-repair-evar-combined-dose-reduction-techniques
#12
Georg Böning, Roman A Rotzinger, Johannes F Kahn, Patrick Freyhardt, Diane M Renz, Martin Maurer, Florian Streitparth
Background Endovascular aneurysm repair (EVAR) requires lifelong surveillance by computed tomography angiography (CTA). This is attended by a substantial accumulation of radiation exposure. Iterative reconstruction (IR) has been introduced to approach dose reduction. Purpose To evaluate adaptive statistical iterative reconstruction (ASIR) at different levels of tube voltage concerning image quality and dose reduction potential in follow-up post EVAR. Material and Methods One hundred CTAs in 67 patients with EVAR were examined using five protocols: protocol A (n = 40) as biphasic standard using filtered back projection (FBP) at 120 kV; protocols B (n = 40), C (n = 10), and D1 (n = 5) biphasic using ASIR at 120, 100, and 80 kV, respectively; and protocol D2 (n = 5) with a monophasic splitbolus ASIR protocol at 80 kV...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29389419/late-type-ii-endoleaks-after-endovascular-aneurysm-repair-require-intervention-more-frequently-than-early-type-ii-endoleaks
#13
Danielle M Pineda, Keith D Calligaro, Sam Tyagi, Douglas A Troutman, Matthew J Dougherty
OBJECTIVE: Type II endoleaks (T2ELs) are commonly observed after endovascular aneurysm repair (EVAR). We sought to determine whether time at onset of T2ELs correlated with the need to intervene based on sac expansion or rupture. METHODS: Between 1998 and 2015, 462 EVARs performed at our institution had duplex ultrasound surveillance in our accredited noninvasive vascular laboratory. Computed tomography and arteriography were reserved for abnormal duplex ultrasound findings...
February 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29384470/the-uk-endovascular-aneurysm-repair-evar-randomised-controlled-trials-long-term-follow-up-and-cost-effectiveness-analysis
#14
Rajesh Patel, Janet T Powell, Michael J Sweeting, David M Epstein, Jessica K Barrett, Roger M Greenhalgh
BACKGROUND: Short-term survival benefits of endovascular aneurysm repair (EVAR) compared with open repair (OR) of intact abdominal aortic aneurysms have been shown in randomised trials, but this early survival benefit is soon lost. Survival benefit of EVAR was unclear at follow-up to 10 years. OBJECTIVE: To assess the long-term efficacy of EVAR against OR in patients deemed fit and suitable for both procedures (EVAR trial 1; EVAR-1); and against no intervention in patients unfit for OR (EVAR trial 2; EVAR-2)...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29327576/is-evar-a-durable-solution-indications-for-reinterventions
#15
REVIEW
Louise de la Motte, Mårten Falkenberg, Mark J Koelemay, Lars Lönn
INTRODUCION: Indications for reinterventions after endovascular aneurysm repair (EVAR), as well as their occurrence in number and time, are important to establish in order to optimize patient selection, postprocedure surveillance and also to guide improvements in endograft designs. The aim of this report was to present an overview of current data on reinterventions after elective EVAR. EVIDENCE ACQUISITION: Qualitative review of studies reporting on reinterventions after elective EVAR, identified by a systematic literature search in MEDLINE, EMBASE and the Cochrane Library for publications from 2010 to 13th of November 2017...
April 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29250445/identification-of-factors-influencing-cumulative-long-term-radiation-exposure-in-patients-undergoing-evar
#16
G Kalender, Milan Lisy, U A Stock, A Endisch, A Kornberger
Patients who undergo endovascular repair of aortic aneurysms (EVAR) require life-long surveillance because complications including, in particular, endoleaks, aneurysm rupture, and graft dislocation are diagnosed in a certain share of the patient population and may occur at any time after the original procedure. Radiation exposure in patients undergoing EVAR and post-EVAR surveillance has been investigated by previous authors. Arriving at realistic exposure data is essential because radiation doses resulting from CT were shown to be not irrelevant...
2017: International Journal of Vascular Medicine
https://www.readbyqxmd.com/read/29249593/evaluation-of-delayed-endoleak-compared-with-early-endoleak-after-endovascular-aneurysm-repair
#17
Trong Binh Le, Keun-Myoung Park, Yong Sun Jeon, Kee Chun Hong, Soon Gu Cho
PURPOSE: To identify prevalence and evaluate outcomes of delayed endoleak (DEL) compared with early endoleak (EEL) after endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: Data of 164 patients who underwent elective EVAR at a single center were retrospectively analyzed. DEL was defined as any type of endoleak that was first detected ≥ 12 months after EVAR. Patients who had < 1 year of follow-up were excluded. Endoleak was classified into a more aggressive category if a patient had > 1 type of endoleak...
February 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29242065/preliminary-results-of-endovascular-aneurysm-sealing-from-the-multicenter-italian-research-on-nellix-endoprosthesis-irene-study
#18
Bruno Gossetti, Ombretta Martinelli, Michelangelo Ferri, Roberto Silingardi, Fabio Verzini
OBJECTIVE: Because of advances in technology and experience of the operator, endovascular aneurysm repair (EVAR) has supplanted open repair to treat abdominal aortic aneurysm (AAA). The low 30-day mortality and morbidity of EVAR make the endovascular approach particularly suitable for patients at high surgical risk. However, endoleak or endograft migration requiring secondary intervention or open surgical conversion is a limitation of EVAR. The Nellix system (Endologix, Inc, Irvine, Calif) has been designed to seal the entire AAA to overcome these limitations with EVAR...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29234732/endovascular-aneurysm-repair-evar-of-an-infrarenal-abdominal-aortic-aneurysm-aaa-in-a-young-patient-with-systemic-lupus-erythematosus-sle
#19
Nick Z P Ng, Tze Tec Chong
Introduction: While hypertension, pericardial, myocardial, and coronary artery disease are common cardiovascular manifestations of systemic lupus erythematosus (SLE), aortic aneurysms (AA) are rare but increasingly diagnosed, with the true incidence unknown. Case report: A 40 year old female suffering from SLE with a 5.3 cm saccular eccentric infrarenal abdominal aortic aneurysm (AAA) was treated successfully with endovascular aneurysm repair (EVAR) using the Medtronic Endurant II bifurcated stent graft and followed up 2 years post-operatively...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29105814/late-onset-type-i-endoleak-characterized-by-contrast-enhanced-ultrasound-after-endovascular-repair-of-aortic-aneurysm
#20
John Nathan Gifford, Hsueh Wen Cheong, Wey Chyi Teoh
We report in the case of a patient with an intra-abdominal aortic aneurysm treated with endovascular aneurysm repair (EVAR) who developed renal impairment during the period of follow up. The repair was complicated with an early-onset type II endoleak which later evolved into a late-onset type I endoleak. It was treated with proximal extension of stent graft, with treatment success and follow-up documented on contrast enhanced ultrasound (CEUS). This case illustrates the usefulness of CEUS in post-EVAR surveillance and emphasizes the need for life-long monitoring as late-onset complications are not uncommon...
November 4, 2017: Journal of Clinical Ultrasound: JCU
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