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FEVAR

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https://www.readbyqxmd.com/read/28483632/chimney-technique-with-the-incraft%C3%A2-aaa-stent-graft-system-to-treat-pararenal-aortic-aneurysm-in-narrowed-iliac-axes
#1
Nunzio Montelione, Pasqualino Sirignano, Wassim Mansour, Martina Formiconi, Laura Capoccia, Francesco Speziale
To report a case of pararenal aortic aneurysm (PAAA) with narrowed iliac arteries treated by the chimney technique combined with the INCRAFT(®) AAA stent graft system. A 75-year-old man was diagnosed with a 55mm PAAA. Patient was judged unfit for open repair and for standard endovascular repair (EVAR) due to its clinical and anatomical requirements. Custom-made fenestrated device (FEVAR) was excluded due to the presence of narrowed and heavily calcified iliac axes. Consequently, patient underwent auspicious endovascular aneurysm repair with the INCRAFT(®) System and chimney grafts in the superior mesenteric artery and both renal arteries...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28401533/long-term-follow-up-of-fenestrated-endovascular-repair-for-juxtarenal-aortic-aneurysm
#2
I N Roy, A M Millen, S M Jones, S R Vallabhaneni, J R H Scurr, R G McWilliams, J A Brennan, R K Fisher
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) is increasingly being used for juxtarenal aortic aneurysms. The aim of this study was to review long-term results and assess the importance of changing stent-graft design on outcomes. METHODS: This was a retrospective review of all patients who underwent FEVAR within a single unit over 12 years (February 2003 to December 2015). Kaplan-Meier analysis of survival, and freedom from target vessel loss, aneurysm expansion, graft-related endoleak and secondary intervention was performed...
April 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#3
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28359793/preoperative-hypoalbuminemia-is-a-risk-factor-for-early-and-late-mortality-in-patients-undergoing-endovascular-juxtarenal-and-thoracoabdominal-aortic-aneurysm-repair
#4
Max Wohlauer, Corey Brier, Yuki Kuramochi, Matthew Eagleton
BACKGROUND: Advances in endovascular aneurysm repair now allow surgeons to treat high-risk patients with complex aortic aneurysms. Stringent selection criteria for repair exist from an anatomic and technical perspective; however, there is a paucity of literature examining frailty in patients being evaluated for fenestrated and branched endovascular aortic repair (FEVAR). As a marker of frailty well supported in the literature, we hypothesized that preoperative hypoalbuminemia would increase risk for short-term mortality after endovascular juxtarenal and thoracoabdominal aortic aneurysm repair...
March 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28359720/the-sequential-catheterization-amid-progressive-endograft-deployment-technique-for-fenestrated-endovascular-aortic-aneurysm-repair
#5
Carlos H Timaran, Gregory A Stanley, M Shadman Baig, David E Timaran, J Gregory Modrall, Martyn Knowles
Fenestrated endovascular aneurysm repair (FEVAR) is an alternative to open repair of complex aortic aneurysms. Despite promising short-term results, the technical complexities of this procedure remain a considerable challenge. The risk of technical failure with loss of visceral or renal arteries is ubiquitous even in the most experienced hands, and thus many patients with unfavorable anatomy are frequently denied FEVAR. We have adopted a new technique for FEVAR that involves retrograde brachial artery access and stepwise deployment of the endograft during target vessel catheterization, overcoming many anatomic limitations encountered from a transfemoral approach...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28342523/early-experience-with-a-modified-preloaded-system-for-fenestrated-endovascular-aortic-repair
#6
MULTICENTER STUDY
Blandine Maurel, Tim Resch, Rafaelle Spear, Blayne Roeder, Umberto M Bracale, Stephan Haulon, Tara M Mastracci
OBJECTIVE: Preloaded endovascular delivery systems expand the anatomic eligibility for complex aortic repair by requiring only one iliac access vessel and providing a stable platform for guiding sheaths into challenging target vessels. This article reports the lessons learned and early clinical outcomes using a modified preloaded delivery system for fenestrated endovascular aneurysm repair (FEVAR) in three aortic centers in Europe. METHODS: From October 2015 to March 2016, consecutive patients presenting with extensive aortic aneurysm treated with a modified preloaded FEVAR were prospectively enrolled from three high volume European aortic centers...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28341507/endovascular-aortic-repair-for-progressive-chronic-thoracoabdominal-aortic-dissections
#7
Vito Mantese, Shameem Kunhammed
BACKGROUND: Ascending and thoracic aortic dissections progress into thoracoabdominal aneurysms 20-40% of the time, due to the initial aortic injury with associated weakness of the aortic wall. The increased firmness of the intimal flap usually results in a collapsed true lumen that does not spontaneously re-expand even with progressive dilatation of the aorta. In an effort to identify a safe and effective treatment path for this complex disease process, we present 4 cases illustrating successful sequential thoracic endovascular aortic repair (TEVAR) and fenestrated endovascular aortic repair (FEVAR)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28335059/retrospective-evaluation-of-percutaneous-access-for-tevar-and-evar-time-to-make-it-the-standard-approach
#8
Rohit Philip Thomas, Tobias Kowald, Bernhard Schmuck, Osama Eldergash, Andreas Klausen, Valentin Dikov, Jerry Easo, Ajay Chavan
Introduction To evaluate the safety of percutaneous endovascular aortic repair and the relationship of access site characteristics to complications Materials and Methods All patients undergoing percutaneous TEVAR, EVAR and FEVAR procedures from January 2010 to May 2016 were retrospectively analysed for incidence of complications and their relationship to various access site characteristics like access artery size, degree of vessel calcification, skin to artery distance and sheath to artery ratio. Hemostasis occurring within 15 min after suture closure with or without manual compression was defined as primary hemostasis...
April 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28285957/comparison-of-renal-outcomes-in-patients-treated-by-zenith-%C3%A2-fenestrated-and-zenith-%C3%A2-abdominal-aortic-aneurysm-stent-grafts-in-us-prospective-pivotal-trials
#9
L R de Souza, G S Oderich, M A Farber, S Haulon, P V Banga, A H Pereira, P Gloviczki, S C Textor, F Jia
OBJECTIVE/BACKGROUND: Fenestrated endovascular repair (FEVAR) has been used to treat complex abdominal aortic aneurysms (AAAs). The risk of renal function deterioration compared with infrarenal endovascular aortic repair (EVAR) has not been determined. METHODS: Patients with preserved renal function (estimated glomerular filtration rate [eGFR] > 45 mL/minute) enrolled in two prospective, non-randomised studies evaluating Zenith fenestrated and AAA stent grafts were matched (1:2) by propensity scores for age, sex, hypertension, diabetes, and pre-operative eGFR...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28238921/geometric-alteration-of-renal-arteries-after-fenestrated-grafting-and-the-impact-on-renal-function
#10
Jiale Ou, Yiu-Che Chan, Crystal Yin-Tung Chan, Stephen W K Cheng
BACKGROUND: This study aims to investigate the degree of geometric change on renal arteries and its impact on renal function after fenestrated endovascular aortic repair (fEVAR). METHODS: Twenty-five patients with fEVAR were included. There were 47 renal arteries target vessels, and 43 of these (22 left and 21 right vessels) stented successfully. Their preoperative and first postoperative follow-up computed tomography (CT) images were reconstructed using the Aquarius workstation (TeraRecon, San Mateo, CA, USA)...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28216359/fenestrated-endovascular-aneurysm-repair-among-octogenarians-at-high-and-standard-risk-for-open-repair
#11
David E Timaran, Martyn Knowles, Tarik Ali, Carlos H Timaran
BACKGROUND: Octogenarians with complex abdominal aortic aneurysms are at higher risk of death and morbidity after open repair. Fenestrated endovascular aneurysm repair (FEVAR) is an alternative to open repair for high-risk patients, such as octogenarians. The aim of this study was to evaluate perioperative and midterm outcomes of FEVAR among octogenarians at high and standard risk for open repair. METHODS: During a 2-year period, 85 patients (68 men [78%] and 17 women [22%]) underwent FEVAR using Zenith (Cook Medical, Bloomington, Ind) Fenestrated AAA Endovascular Grafts (70%), Zenith p-Branch (7%), and fenestrated custom-made devices (22%)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28205454/graft-complexity-related-outcomes-of-fenestrated-endografting-for-abdominal-aortic-aneurysms
#12
Kyriakos Oikonomou, Piotr Kasprzak, Wilma Schierling, Reinhard Kopp, Karin Pfister
PURPOSE: To report the outcomes of fenestrated endovascular aneurysm repair (FEVAR) and compare early and midterm results in relation to stent-graft complexity. METHODS: Between August 2006 and December 2014, 141 consecutive patients (mean age 72±7.6 years, range 50-89; 120 men) were treated electively with FEVAR for short-neck, juxtarenal, or suprarenal aortic aneurysms. Forty-five patients treated with stent-grafts featuring renal-only fenestrations were assigned to group A, while 96 patients receiving additional fenestrations for the superior mesenteric and/or celiac arteries were assigned to group B...
February 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28139092/the-role-of-learning-in-health-technology-assessments-an-empirical-assessment-of-endovascular-aneurysm-repairs-in-german-hospitals
#13
Yauheniya Varabyova, Carl Rudolf Blankart, Jonas Schreyögg
Changes in performance due to learning may dynamically influence the results of a technology evaluation through the change in effectiveness and costs. In this study, we estimate the effect of learning using the example of two minimally invasive treatments of abdominal aortic aneurysms: endovascular aneurysm repair (EVAR) and fenestrated EVAR (fEVAR). The analysis is based on the administrative data of over 40,000 patients admitted with unruptured abdominal aortic aneurysm to more than 500 different hospitals over the years 2006 to 2013...
February 2017: Health Economics
https://www.readbyqxmd.com/read/28125784/incidence-and-clinical-significance-of-renal-infarct-after-fenestrated-endovascular-aortic-aneurysm-repair
#14
Lauren M B Burke, Jesse M Conyers, Charles T Burke, Robert Dixon, Hyeon Yu, Jeremy Kim, Raghuveer Vallabhaneni, Mark A Farber, Ari J Isaacson
OBJECTIVE: The purpose of this study is to determine the incidence and clinical significance of renal infarcts after fenestrated endovascular aortic aneurysm repair (FEVAR). MATERIALS AND METHODS: All patients who underwent FEVAR with unenhanced and contrast-enhanced CT angiography during a 4-year period were retrospectively reviewed. Two staff radiologists reviewed pre- and post-FEVAR CT examinations for the presence of renal infarcts. Pre- and postoperative serum creatinine levels were examined to determine statistical significance...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27978899/-preliminary-study-of-endovascular-aneurysm-repair-using-fenestration-on-table-for-abdominal-aortic-aneurysm-with-short-proximal-neck
#15
J C Zhu, F G Hu, Y W Zhang, Z Feng, H L Fan, Y D Luo, X C Dai
Objective: To investigate the clinical value of endovascular aneurysm repair(EVAR) using fenestration on table for abdominal aortic aneurysm(AAA) with short proximal neck. Methods: A retrospective analysis of four cases with short proximal neck AAA from Aug. 2015 to May. 2016 of Tianjin Medical University General Hospital treated by EVAR using fenestration on table. Fenestrated stent-grafts were designed according to the preoperative computer tomography angiography(CTA) data. All cases underwent EVAR with the fenestrated stent-grafts on table to revascularize visceral branches...
December 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27908809/a-combination-of-thoracic-and-abdominal-stent-grafts-to-treat-an-abdominal-aortic-aneurysm-with-hostile-proximal-neck
#16
Mafalda Massara, Roberto Prunella, Pasquale Gerardi, Giovanni De Caridi, Raffaele Serra, Stefano Notarstefano, Giovanni Impedovo
Endovascular aneurysm repair (EVAR) actually represents the treatment of choice for most patients affected by abdominal aortic aneurysm (AAA). However, the feasibility of EVAR depends on anatomical characteristics of abdominal aorta and iliofemoral axis. We present the case of an 82-year-old man affected by severe left hydronephrosis, kidney tumor, and ureteral tumor requiring nephrectomy, who also presented a very voluminous AAA with a large diameter (96 mm), and a large proximal neck (39 mm) with severe angulation of the proximal neck (>60°)...
February 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27889203/changes-in-renal-anatomy-after-fenestrated-endovascular-aneurysm-repair
#17
B Maurel, Y Lounes, M Amako, D Fabre, A Hertault, J Sobocinski, R Spear, R Azzaoui, T M Mastracci, S Haulon
OBJECTIVE: To assess short- and long-term movement of renal arteries after fenestrated endovascular aortic repair (FEVAR). METHODS: Consecutive patients who underwent FEVAR at one institution with a custom-made device designed with fenestrations for the superior mesenteric (SMA) and renal arteries, a millimetric computed tomography angiography (CTA), and a minimum of 2 years' follow-up were included. Angulation between renal artery trunk and aorta, clock position of the origin of the renal arteries, distance between renal arteries and SMA, and target vessel occlusion were retrospectively collected and compared between the pre-operative, post-operative (<6 months), and last (>12 months) CTA...
January 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27743805/progressive-shortfall-in-open-aneurysm-experience-for-vascular-surgery-trainees-with-the-impact-of-fenestrated-and%C3%A2-branched-endovascular-technology
#18
Anahita Dua, Steven Koprowski, Gilbert Upchurch, Cheong J Lee, Sapan S Desai
BACKGROUND: In 2014, we published a series of articles in the Journal of Vascular Surgery that detailed the decrease in volume of open aneurysm repair (OAR) completed for abdominal aortic aneurysm (AAA) by vascular surgery trainees. At that time, only data points from 2000 through 2011 were available, and reliable predictions could only be made through 2015. Lack of data on endovascular aneurysm repair (EVAR) using fenestrated (FEVAR) and branched (BrEVAR) endografts also affected our findings...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27728949/fenestrated-endografts-for-complex-abdominal-aortic-aneurysm-repair
#19
Arne de Niet, Michel Mpj Reijnen, Ignace Fj Tielliu, Jan Willem Hp Lardenoije, Clark J Zeebregts
Since the introduction of fenestrated endovascular aneurysm repair (FEVAR) in 1996, great advances have been made in endograft development. Custom-made and off-the-shelf fenestrated and branched endografts have been used to treat patients with complex abdominal aortic and thoraco-abdominal aneurysms. Most experience has been gained with the Cook Zenith® fenestrated endograft (Cook Medical Inc., Limerick, Ireland). The Cook Zenith® endograft is customized with fenestrations, (fixed) inner or outer branches, or a combination of them, to cover a wide range of complex aneurysms...
October 6, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27575815/evaluation-of-the-learning-curve-for-fenestrated-endovascular-aneurysm-repair
#20
Benjamin W Starnes, Michael T Caps, Zachary M Arthurs, Billi Tatum, Niten Singh
OBJECTIVE: The objective of this study was to evaluate the learning curve for fenestrated endovascular aortic aneurysm repair (FEVAR). METHODS: Data were collected prospectively on all FEVAR procedures conducted by a single surgeon between June 2007 and January 2015. During the study period, 136 FEVARs were performed, and this experience was divided into four quartiles each consisting of 34 cases. Clinical outcomes evaluated included perioperative death and major complications...
November 2016: Journal of Vascular Surgery
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