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Seline R Goudeketting, Jan Wille, Daniel A F van den Heuvel, Jan-Albert Vos, Jean-Paul P M de Vries
PURPOSE: To review midterm clinical outcomes of EndoAnchor placement during or after endovascular aneurysm repair (EVAR) or chimney EVAR (ch-EVAR). MATERIALS AND METHODS: A retrospective analysis was conducted of 51 consecutive patients [median age 75 years; 38 men] who underwent EVAR/ch-EVAR with EndoAnchor placement between June 2010 and December 2016 to prevent seal failures (31, 61%) or to treat type Ia endoleak and/or migration (20, 39%). Median aortic neck diameter was 27...
December 4, 2018: Journal of Endovascular Therapy
Kyriakos Oikonomou, Piotr Kasprzak, Wilma Schierling, Reinhard Kopp, Karin Pfister
Complications during follow-up - including loss of seal and graft migration with endoleakage - are the Achilles heel of endovascular abdominal and thoracic aneurysm repair (EVAR and TEVAR, respectively). At the level of the proximal and distal landing zones, the characteristics of aortic anatomy include length and shape, thrombus, calcification, kinking and progressive dilatation, and these may impact the long-term durability of endovascular repair. Endoanchors have been shown to mimic the stability of a hand sewn aortic anastomosis...
October 2018: Zentralblatt Für Chirurgie
Nelson F G Oliveira, Frederico Bastos Gonçalves, Klaas Ultee, José Pedro Pinto, Marie Josee van Rijn, Sander Ten Raa, Patrice Mwipatayi, Dittmar Böckler, Sanne E Hoeks, Hence J M Verhagen
OBJECTIVE: Standard endovascular aneurysm repair (EVAR) is the most common treatment of abdominal aortic aneurysms (AAAs). EVAR has been increasingly used in patients with hostile neck features. This study investigated the outcomes of EVAR in patients with neck diameters ≥30 mm in the prospectively maintained Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). METHODS: This is a retrospective study comparing patients with neck diameters ≥30 mm with patients with neck diameters <30 mm...
October 3, 2018: Journal of Vascular Surgery
Seline R Goudeketting, Kim van Noort, Kenneth Ouriel, William D Jordan, Jean M Panneton, Cornelis H Slump, Jean-Paul P M de Vries
OBJECTIVE: This study sought to quantify EndoAnchor (Medtronic Vascular, Santa Rosa, Calif) penetration into the aortic wall in patients undergoing endovascular abdominal aortic aneurysm repair and to assess predictors of successful penetration and its relationship to postprocedural type IA endoleak. METHODS: A subset of patients from the Aneurysm Treatment Using the Heli-FX Aortic Securement System Global Registry (ANCHOR) were included if they met the following criteria: the indication for EndoAnchor use was to treat a type IA endoleak, and postprocedure contrast-enhanced computed tomography (CT) scans of sufficient quality were available for core laboratory review...
April 21, 2018: Journal of Vascular Surgery
Rami O Tadros, Alex Sher, Martin Kang, Ageliki Vouyouka, Windsor Ting, Daniel Han, Michael Marin, Peter Faries
OBJECTIVE: The ideal treatment option for patients with complex aneurysm morphology remains highly debated. The aim of this study was to investigate the impact of endovascular aneurysm repair (EVAR) with active fixation on outcomes in patients with complex aneurysm morphology. METHODS: There were 340 consecutive patients who underwent EVAR using active fixation devices, 234 with active infrarenal fixation (AIF; Gore Excluder; W. L. Gore & Associates, Flagstaff, Ariz) and 106 with active suprarenal fixation (ASF; 85 Medtronic Endurant [Medtronic, Santa Rosa, Calif] and 21 Cook Zenith [Cook Medical, Bloomington, Ind])...
September 2018: Journal of Vascular Surgery
Andrés Reyes Valdivia, Claudio Gandarias Zúñiga
No abstract text is available yet for this article.
May 2018: European Journal of Vascular and Endovascular Surgery
Bart E Muhs, William Jordan, Kenneth Ouriel, Sareh Rajaee, Jean-Paul de Vries
OBJECTIVE: The objective of this study was to examine whether prophylactic use of EndoAnchors (Medtronic, Santa Rosa, Calif) contributes to improved outcomes after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms through 2 years. METHODS: The Aneurysm Treatment Using the Heli-FX Aortic Securement System Global Registry (ANCHOR) subjects who received prophylactic EndoAnchors during EVAR were considered for this analysis. Imaging data of retrospective subjects who underwent EVAR at ANCHOR enrolling institutions were obtained to create a control sample...
June 2018: Journal of Vascular Surgery
Andrés Reyes Valdivia, Africa Duque Santos, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
PURPOSE: To present a case of a patient with possible short (2 years approximately) life expectancy and a 68-mm abdominal aortic aneurysm with a large infrarenal neck and large suprarenal aorta that precluded chimney endovascular aortic repair (Ch-EVAR) treatment. MATERIALS AND METHODS: The technical aspects of a modification of the funnel technique (thoracic endograft as a proximal extension of a main infrarenal device in wide necks) are described. We advocated a migrated bifurcated 36-mm endograft in a 34-mm native aorta, ten mm below the lowest renal artery and added endoanchor (four) fixation to this "intentionally migrated main endograft...
February 2018: Cardiovascular and Interventional Radiology
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)...
December 2017: International Angiology: a Journal of the International Union of Angiology
Jacob Budtz-Lilly, Kiattisak Hongku, Björn Sonesson, Nuno Dias, Tim Resch
Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger abdominal aortic aneurysm necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing...
December 2017: Journal of Cardiovascular Surgery
Georgios A Pitoulias, Andrés Reyes Valdivia, Suteekhanit Hahtapornsawan, Giovanni Torsello, Apostolos G Pitoulias, Martin Austermann, Claudio Gandarias, Konstantinos P Donas
OBJECTIVE: Hostile proximal aortic neck (HN) challenges the suitability for standard endovascular aneurysm repair (EVAR) of patients at high risk for "open" repair. However, there has been little if any focus placed on the individual role of the "nonlength" HN features in EVAR outcomes. The aim of this study was to evaluate their individual and potentially predictive role in outcomes of EVAR under HN conditions. METHODS: Data of 156 consecutive EVAR patients with short (<15 mm) HN, treated with the Endurant device (Medtronic Cardiovascular, Santa Rosa, Calif) at three European academic vascular centers between 2007 and 2015, were collected and retrospectively analyzed...
December 2017: Journal of Vascular Surgery
Apostolos K Tassiopoulos, Spyridon Monastiriotis, William D Jordan, Bart E Muhs, Kenneth Ouriel, Jean Paul De Vries
OBJECTIVE: Dilatation of the aorta within the proximal neck after endovascular aneurysm repair (EVAR) can be associated with late endoleaks and migration. This study was designed to identify predictors of early neck dilation in patients undergoing EVAR with Heli-FX EndoAnchors (Medtronic, Santa Rosa, Calif) measured perioperatively to 1 year at different longitudinal levels of neck length. METHODS: The study group of Aneurysm Treatment Using the Heli-FX Aortic Securement System (ANCHOR) comprises 257 consecutive patients prospectively enrolled between April 2012 and September 2014 undergoing EVAR with Heli-FX EndoAnchor implantation at 38 investigational sites...
July 2017: Journal of Vascular Surgery
F J V Schlösser, J P P M de Vries, A Chaudhuri
No abstract text is available yet for this article.
April 2017: European Journal of Vascular and Endovascular Surgery
Sarah B Ongstad, Daniel F Miller, Jean M Panneton
BACKGROUND: The aim of this study was to assess the applicability and outcomes of EndoAnchor use in the endovascular repair of thoracic and thoracoabdominal aortic aneurysms. METHODS: A retrospective review was performed of all thoracic endovascular aortic repairs (TEVARs) performed with the use of EndoAnchors between December 2012 and January 2016. Primary study endpoints included freedom from migration, freedom from aortic- related intervention, and freedom from post-operative type I or type III endoleak...
October 2016: Journal of Cardiovascular Surgery
Rohan S Menon, Corbin Muetterties, George William Moser, Grayson H Wheatley
As more challenging aortic arch anatomy is being treated using aortic stent-grafts, there is an increased risk for proximal Type I endoleaks at the proximal seal zone or subsequent graft migration. We report a case of an endoanchor-assisted thoracic endovascular aneurysm repair of a patient with an aberrant right subclavian artery (ARSA) and aortic arch aneurysm who developed a proximal Type I endoleak in the aortic arch which was subsequently treated with endoanchors.
August 2016: Journal of Cardiac Surgery
Menno T de Bruijn, Erik Tournoij, Daniel Af van den Heuvel, Debbie de Vries-Werson, Jan Wille, Jean-Paul Pm de Vries
PURPOSE: To describe an off-the-shelf method for the treatment of abdominal aortic aneurysms with hostile (large, >30 mm) neck and/or small (<20 mm) aortic bifurcation. CASE REPORT: We describe five patients with large aortic necks and/or small aortic bifurcations, which were treated by combining an AFX endoprosthesis with a Valiant Captiva endograft, and additional proximal endoanchors when deemed necessary. Initial technical success was 100%. Follow-up ranged from 228 to 875 days...
August 2016: Vascular
Tulio Pinho Navarro, Rodrigo de Castro Bernardes, Ricardo Jayme Procopio, Jose Oyama Leite, Alan Dardik
Endovascular aneurysm repair (EVAR) is a therapy that continues to evolve rapidly as advances in technology are incorporated into new generations of devices and surgical practice. Although EVAR has emerged as a safe and effective treatment for patients with favorable anatomy, treatment of patients with unfavorable anatomy remains controversial and is still an off-label indication for endovascular treatment with some current stent-grafts. The proximal neck of the aneurysm remains the most hostile anatomic barrier to successful endovascular repair with long-term durability...
February 2014: Aorta (Stamford, Conn.)
Richte C L Schuurmann, Kenneth Ouriel, Bart E Muhs, William D Jordan, Richard L Ouriel, Johannes T Boersen, Jean-Paul P M de Vries
OBJECTIVE: Hostile infrarenal neck characteristics are associated with complications such as type Ia endoleak after endovascular aneurysm repair. Aortic neck angulation has been identified as one such characteristic, but its association with complications has not been uniform between studies. Neck angulation assumes triangular oversimplification of the aortic trajectory, which may explain conflicting findings. By contrast, aortic curvature is a measurement that includes the bending rate and tortuosity and may provide better predictive value for neck complications...
March 2016: Journal of Vascular Surgery
Edgar Luis Galiñanes, Eduardo Hernandez, Zvonimir Krajcer
OBJECTIVES: To present our initial experience with the use of EndoAnchors for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) with little to no infrarenal landing zone. BACKGROUND: EndoAnchors have been reported to assist in the prevention and treatment of type 1a endoleaks in patients with hostile aortic necks who undergo EVAR. METHODS: Between July 2013 and July 2014, nine patients with AAAs and short proximal aortic necks (i...
March 2016: Catheterization and Cardiovascular Interventions
Esmé J Donselaar, Rozemarijn J van der Vijver-Coppen, Leo H van den Ham, Jan Willem H P Lardenoye, Michel M P J Reijnen
PURPOSE: To describe 2 patients with a distally migrated endograft causing a type Ia endoleak and treatment with a proximal cuff and chimney grafts that required EndoAnchors to finally seal the leak. CASE REPORT: Two men, ages 86 and 72 years, presented with stent-graft migration and type Ia endoleak at 5 and 15 years after endovascular repair, respectively. Both were treated with a proximal cuff in combination with a chimney graft to the left renal artery. In both cases, the type Ia endoleak persisted, likely due to gutter formation...
February 2016: Journal of Endovascular Therapy
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