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https://www.readbyqxmd.com/read/28895367/is-management-of-complex-abdominal-aortic-aneurysms-consistent-across-the-uk-a-questionnaire-based-survey
#1
Eleanor Atkins, Ranjeet Narlawar, Francesco Torella, George A Antoniou
BACKGROUND: Our objective was to quantify variability across the UK in the management of a complex abdominal aortic aneurysm (AAA). METHODS: An online survey was emailed to all members of the Vascular Society for Great Britain and Ireland. The survey presented a vignette of a 63-year-old woman with significant respiratory co-morbidity whose computed tomographic (CT) angiogram demonstrated a 54 mm AAA with a short (7 mm) proximal neck but no other adverse morphological features for a standard or complex endovascular aneurysm repair (EVAR)...
September 11, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28876594/salmonella-typhimurium-infected-abdominal-aortic-aneurysm-endovascular-repair-with-secondary-aortoenteric-fistula-formation
#2
M Dickfos, K Garnham, J Jenkins
Endovascular aneurysm repair (EVAR) is a widely accepted and used technique for the treatment of abdominal aortic aneurysms (AAA). However, it comes with a unique set of complications, two of the rarer being infection and aorto-enteric fistula formation. Due to the infrequency of the situation, there are currently no guidelines for their management. A 75-year-old male presented with vague abdominal pain and fevers. He was diagnosed with an infected abdominal aortic EVAR stent graft on computer tomography imaging...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28822680/outcomes-of-endovascular-abdominal-aortic-aneurysm-repair-in%C3%A2-octogenarians-meta-analysis-and-systematic-review
#3
REVIEW
Y Han, S Zhang, J Zhang, C Ji, H-H Eckstein
OBJECTIVES: This meta-analysis and systematic review aimed to highlight the results of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) to assess safety and effectiveness in patients older than 80 years of age compared with younger patients. METHODS: PRISMA guidelines were used; quality was appraised, and data were extracted and analysed following the Cochrane collaboration. The MEDLINE and Embase databases were searched on December 31, 2016...
August 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28782417/improving-patient-compliance-with-post-evar-surveillance-may-prevent-late-rupture
#4
Alicia L Skervin, Chung S Lim, Kaji Sritharan
Endovascular aneurysm repair (EVAR) has gained increasing popularity in the treatment of infrarenal abdominal aortic aneurysm. Despite its favorable early outcomes, the long-term efficacy of EVAR remains a concern. Late rupture is the ultimate treatment failure and continues to complicate EVAR. Univariate and multivariate analyses have identified factors predictive of late rupture. The importance of EVAR surveillance to prevent late complications is equally widely acknowledged. This article aims to present our current understanding of the precipitating factors of late rupture after EVAR and explores whether the key to its prevention lies within improving patient factors, particularly compliance to follow-up appointments or whether physicians hold the solution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28765015/the-impact-of-compliance-with-imaging-follow-up-on-mortality-after-endovascular-abdominal-aortic-aneurysm-repair-a-population-based-cohort-study
#5
C de Mestral, R Croxford, N Eisenberg, G Roche-Nagle
OBJECTIVE: Compliance with regular imaging follow-up after endovascular aortic aneurysm repair (EVAR) is inconsistent, and evidence of benefit from scheduled long-term surveillance is limited. This study sought to characterize the association between post-EVAR imaging frequency and long-term survival. METHODS: Using administrative health databases for the province of Ontario, Canada, a cohort of patients was identified who underwent EVAR between 2004 and 2014. Minimum appropriate imaging follow-up (MAIFU) was defined as a CT scan or ultrasound of the abdomen within 90 days of EVAR as well as every 15 months thereafter...
July 29, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28685522/next-generation-post-evar-follow-up-regime
#6
Rita Soares Ferreira, Frederico Bastos Gonçalves
Durability of endovascular aneurysm repair is critical, since a significant proportion of patients suffer from procedure-related complications and secondary interventions after repair of abdominal aortic aneurysms. Therefore, regular follow up including imaging is recommended. The rationale behind current surveillance programs is to allow early detection and elective treatment of complications. However, current recommendations are laborious and resource consuming, may be deleterious to many patients and are largely inefficient...
July 7, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28662928/surveillance-after-endovascular-aortic-repair
#7
Feras Zaiem, Jehad Almasri, Mouaffaa Tello, Larry J Prokop, Elliot L Chaikof, Mohammad Hassan Murad
OBJECTIVE: The objective of this systematic review and meta-analysis was to evaluate the optimal modality and frequency of surveillance after endovascular aortic repair (EVAR) in adult patients with abdominal aortic aneurysms. METHODS: We searched for studies of post-EVAR surveillance in MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Scopus through May 10, 2016. The outcomes of interest were endoleaks, mortality, limb ischemia, renal complications, late rupture, and aneurysm-related mortality...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28656809/a-systematic-review-of-predictors-of-reintervention-after-evar-guidance-for-risk-stratified-surveillance
#8
REVIEW
Shaneel R Patel, Chris Allen, Matthew J Grima, Jack R W Brownrigg, Benjamin O Patterson, Peter J E Holt, Matt M Thompson, Alan Karthikesalingam
BACKGROUND: Current surveillance protocols after endovascular aneurysm repair (EVAR) are ineffective and costly. Stratifying surveillance by individual risk of reintervention requires an understanding of the factors involved in developing post-EVAR complications. This systematic review assessed risk factors for reintervention after EVAR and proposals for stratified surveillance. METHODS: A systematic search according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed using EMBASE and MEDLINE databases to identify studies reporting on risk factors predicting reintervention after EVAR and proposals for stratified surveillance...
August 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28598495/ultrasonography-for-endoleak-detection-after-endoluminal-abdominal-aortic-aneurysm-repair
#9
REVIEW
Iosief Abraha, Maria Laura Luchetta, Rita De Florio, Francesco Cozzolino, Giovanni Casazza, Piergiorgio Duca, Basso Parente, Massimiliano Orso, Antonella Germani, Paolo Eusebi, Alessandro Montedori
BACKGROUND: People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. OBJECTIVES: To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS) in terms of sensitivity and specificity for endoleak detection after endoluminal abdominal aortic aneurysm repair (EVAR)...
June 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28580349/ultrasound-fusion-imaging-with-real-time-navigation-for-the-surveillance-after-endovascular-aortic-aneurysm-repair
#10
Jin Hyun Joh, Sang-Ah Han, Sang-Hyun Kim, Ho-Chul Park
Ultrasound can be an effective alternative to computed tomography for surveillance following endovascular aneurysm repair (EVAR). Recently, ultrasound fusion imaging with the real-time navigation system was introduced. Here we described 3 patients who underwent post-EVAR surveillance using this novel technique. Complete coregistration was achieved in all patients. The origin of left renal artery was selected for the target of coregistration. Ultrasound fusion imaging was useful to differentiate the confusing lesion and to evaluate the complete resolution of endoleak and newly developed delayed endoleak...
June 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28579278/higher-30-day-mortality-in-patients-with-familial-abdominal-aortic-aneurysm-after-evar
#11
K M van de Luijtgaarden, F Bastos Gonçalves, S E Hoeks, J D Blankensteijn, D Böckler, R J Stolker, H J M Verhagen
OBJECTIVES: To determine the influence of a positive family history for aneurysms on clinical success and mortality after endovascular aneurysm repair (EVAR). METHODS: From 2009 to 2011, 1262 patients with abdominal aortic aneurysms (AAA) treated by EVAR were enrolled in a prospective, industry sponsored clinical registry ENGAGE. Patients were classified into familial and sporadic AAA patients according to baseline clinical reports. Clinical characteristics, aneurysm morphology, and follow-up were registered...
June 1, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28578623/definition-of-type-ii-endoleak-risk-based-on-preoperative-anatomical-characteristics
#12
Michele Piazza, Francesco Squizzato, Tommaso Miccoli, Sandro Lepidi, Mirko Menegolo, Franco Grego, Michele Antonello
PURPOSE: To define the risk for type II endoleak (EII) after endovascular aneurysm repair (EVAR) based on preoperative anatomical characteristics. METHODS: Between January 2008 and December 2015, 189 patients (mean age 78.4±7.6 years; 165 men) underwent standard EVAR. Mean aneurysm diameter was 5.7±0.7 cm and mean volume 125.2±45.8 cm(3). Patients were assigned to the "at-risk" group (n=123, 65%) when at least one of the following criteria was present: patency of a >3-mm inferior mesenteric artery (IMA), patency of at least 3 pairs of lumbar arteries, or patency of 2 pairs of lumbar arteries and a sacral artery or accessory renal artery or any diameter patent IMA; otherwise, patients were entered in the "low-risk" group (n=66, 35%)...
August 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28549961/preliminary-results-of-aorfix-tm-stent-graft-to-treat-infrarenal-abdominal-aortic-aneurysms-with-severe-proximal-aortic-neck-angulation
#13
Pietro Volpe, Mafalda Massara, Antonino Alberti, Santo Marino, Alberto Volpe, Daniela Mazzaccaro, Silvia Stegher, Giovanni Nano
BACKGROUND: We report a preliminary experience about endovascular aortic repair (EVAR) of infrarenal abdominal aneurysm (iAAA) with severe proximal aortic neck angulation using the Aorfix(TM) stent graft. METHODS: Data of consecutive patients with iAAA with severe proximal neck angulation submitted to endovascular repair between September 2012 and December 2014 in two Italian centres of Vascular and Endovascular Surgery were retrospectively reviewed and outcomes analyzed using the software JMP 5...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28535732/duplex-ultrasound-surveillance-after-uncomplicated-endovascular-abdominal-aortic-aneurysm-repair
#14
Jacob S Schaeffer, Irina Shakhnovich, Kyle N Sieck, Kara J Kallies, Clark A Davis, Thomas H Cogbill
OBJECTIVES: Health-care costs and risks of radiation and intravenous contrast exposure challenge computed tomography angiography (CTA) as the standard surveillance method after endovascular abdominal aortic aneurysm repair (EVAR). We reviewed our experience using Duplex ultrasound scan (DUS) as an initial and subsequent surveillance technique after uncomplicated EVAR. METHODS: The medical records of patients who underwent EVAR from 2004 to 2014 with at least 1 postoperative imaging study were retrospectively reviewed...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28501665/a-dedicated-surveillance-program-improves-compliance-with-evar-follow-up
#15
Jade Cohen, Akila Pai, Timothy M Sullivan, Peter Alden, Jason Q Alexander, Andrew Cragg, Jesse M Manunga, Stephenson, Nedaa Skeik, Jessica M Titus
INTRODUCTION: Current recommendations suggest lifetime followup for EVAR patients to avoid consequences associated with endoleak and aneurysm enlargement. Followup compliance has been reported between 43-92%, with most single-center studies citing successful followup surveillance at less than 60%. We investigated followup completeness with a defined surveillance program and subsequent secondary intervention prevalence from a single center. METHODS: Our surveillance program notified patients of the need for followup imaging and surgeon review...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28501663/under-utilization-of-routine-ultrasound-surveillance-after-endovascular-aortic-aneurysm-repair
#16
Matthew W Mell, Trit Garg, Laurence C Baker
INTRODUCTION AND OBJECTIVES: Since 2009 the Society for Vascular Surgery has advocated annual surveillance imaging with ultrasound (US) after the first post-operative year for uncomplicated endovascular aneurysm repairs (EVAR). We sought to describe diffusion of US into long-term routine surveillance and to estimate potential cost savings among Medicare beneficiaries after EVAR. METHODS: Using Medicare claims data we identified patients receiving EVAR from 2002 to 2010 and included only those who did not subsequently have re-interventions, late aneurysm-related complications or death...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28436300/ten-year-single-centre-experience-with-type-ii-endoleaks-intervention-versus-observation
#17
COMPARATIVE STUDY
Ikram-Ul Haq, Arun Kelay, Meryl Davis, Jocelyn Brookes, Tara M Mastracci, Jason Constantinou
Our objective was to determine the relative merits of intervention or observation of type II endoleaks (T2Ls). A retrospective analysis was performed on 386 infra-renal endovascular aneurysm repair (IR-EVAR) patients from 2006 to 2015. Annual surveillance imaging of patients undergoing EVAR at our centre were analysed, and all endoleaks were subjected to a multidisciplinary team meeting for consideration and treatment. In the 10-year time frame, 386 patients (79.5±8.7 years) underwent an IR-EVAR. Eighty-one patients (21...
August 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28390913/could-preoperative-neck-anatomy-influence-follow-up-of-evar
#18
Antonio Giménez-Gaibar, Elena González-Cañas, Teresa Solanich-Valldaura, Carolina Herranz-Pinilla, Sara Rioja-Artal, Elisabeth Ferraz-Huguet
BACKGROUND: The aim of the study was to assess the clinical utility of strict CT scan surveillance after endovascular abdominal aneurysm repair (EVAR) and evaluate whether the anatomy of abdominal aortic aneurysm (AAA) neck (favorable/hostile) influences regular imaging control. METHODS: A retrospective study of AAA patients who underwent EVAR with aortobi-iliac endoprostheses during 2006-2013 was conducted. Exclusion criteria included other types of devices. Variables analyzed were technical and clinical success, morbimortality, complications (such as endoleaks, sac enlargement), reinterventions, reintervention-free survival, and survival rate...
August 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28216351/the-fate-of-endovascular-aortic-aneurysm-repair-after-5%C3%A2-years-monitored-with-duplex-ultrasound-imaging
#19
MULTICENTER STUDY
Danielle M Pineda, Zachary M Phillips, Keith D Calligaro, Emilia Krol, Matthew J Dougherty, Douglas A Troutman, Alan Dietzek
BACKGROUND: Interventions for aortic aneurysm sac growth have been reported across multiple time points after endovascular aortic aneurysm repair (EVAR). We report the long-term outcomes of patients after EVAR monitored with duplex ultrasound (DUS) imaging with respect to the need for and type of intervention after 5 years. METHODS: We report a series of patients who were monitored with DUS imaging for a minimum of 5 years after EVAR. DUS imaging was performed in an accredited noninvasive vascular laboratory, and computed tomography angiography was only performed for abnormal DUS findings...
August 2017: Journal of Vascular Surgery
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
#20
MULTICENTER STUDY
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...
June 2017: Journal of Vascular Surgery
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