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https://www.readbyqxmd.com/read/28434700/incidence-etiology-and-management-of-type-iii-endoleak-after-endovascular-aortic-repair
#1
Geert Maleux, Lien Poorteman, Annouschka Laenen, Bertrand Saint-Lèbes, Sabrina Houthoofd, Inge Fourneau, Hervé Rousseau
OBJECTIVE: The objective of this study was to retrospectively assess the incidence, etiology, and management of type III endoleaks in a large cohort of patients treated with endovascular aneurysm repair (EVAR) in two European university centers. METHODS: From 1995 until 2014, 965 EVAR procedures were performed with use of first- and second-generation (n = 79) or third-generation (n = 886) endografts. Radiologic follow-up was performed with computed tomography and abdominal plain film examinations in accordance with the European Collaborators on Stent/graft Techniques for aortic Aneurysm Repair (EUROSTAR) scheme...
April 20, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#2
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28410923/infrarenal-endograft-clamping-in-late-open-conversions-after-endovascular-abdominal-aneurysm-repair
#3
Paolo Perini, Alessandro de Troia, Tiziano Tecchio, Matteo Azzarone, Claudio Bianchini Massoni, Pierfranco Salcuni, Antonio Freyrie
OBJECTIVE: The aim of this study was to report the technical aspects and outcomes of late open conversion (LOC) after endovascular aneurysm repair (EVAR) in a single center by using exclusively infrarenal clamping of the endograft as an alternative to suprarenal or supraceliac aortic clamping. METHODS: A retrospective analysis of EVAR requiring late explantation (>30 days) from January 1996 to October 2016 was performed. Patients' demographics, type of endograft, duration of implantation, reason for removal, extent of stent graft removal, type of reconstruction, 30-day mortality, postoperative complications, and long-term survival were obtained for analysis...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389292/laparoscopic-transarterial-embolization-of-type-ii-endoleak-after-branched-fenestrated-thoracoabdominal-aortic-aneurysm-endovascular-repair
#4
Gian Franco Fadda, Holta Kasemi, Costantino Luca Di Angelo, Carlo De Nisco, Francesco Balestra, Antonio Cruccu, Mario Marino
Type II endoleak is the most frequent procedure-related complication during endovascular aneurysm exclusion. Actually there is little controversy in the management of type I and III endoleak, while type II endoleak still generates conflicting reports about their timing and type of treatment. Currently, the intervention is needed only in case of sac enlargement, but not in case of persistent endoleak alone. We report the case of a 77 year-old man treated with a custom-made branched/fenestrated endograft for a type III thoracoabdominal aortic aneurysm...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389291/a-word-of-caution-for-extra-large-self-expandable-nitinol-stents
#5
Andrés Reyes Valdivia, Africa Duque Santos, Francisco Alvarez Marcos, Asunción Romero Lozano, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
PURPOSE: To report an unsuccessful use of large nitinol stent to prevent proximal endoleak in endograft treatment for juxtarenal aortic aneurysm. CASE REPORT: Male of 82 years old, with coronary disease and severe chronic obstructive pulmonary disease (COPD) requiring oxygen support. A large 80 mm. juxtarenal aneurysm was found on routine urological examination. Neck features were as follows: 7mm and high anterior-posterior angulation. ASA IV was given. Patient wanted to be treated...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#6
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389286/decision-to-interrupt-second-stage-side-branch-completion-in-thoracoabdominal-branched-aortic-stent-grafting-to-prevent-spinal-cord-ischemia
#7
Joseph Touma, Bachir Benamara, Hicham Kobeiter, Pascal Desgranges
PURPOSE: To describe voluntary interruption of side-branch completion in staged branched endovascular aneurysm treatment due to uncertainty regarding spinal cord ischemia (SCI) possible onset, based on intraoperative angiography findings. CASE REPORT: We report a case of a staged endovascular treatment of thoracoabdominal aortic aneurysm in a 64 year-old patient using a branched endograft with an additional side branch that allows temporary sac perfusion (TASP) to prevent spinal cord ischemia...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28377913/acute-type-b-aortic-dissection-in-a-patient-with-previous-endovascular-abdominal-aortic-aneurysm-repair
#8
Sung Hun Park, Seung-Woon Rha
Endovascular aortic repair (EVAR) was relatively safe, and became a widely performed procedure. If aortic dissection (AD) occurred in patient with previous EVAR, it could cause fatal complications like endograft collapse. Surgical treatment was limited in this situation for comorbidities and complex anatomies. Here we report a rare case of acute type B AD developed following trans-radial coronary intervention in a patient with previous EVAR of abdominal aortic aneurysm, which was treated with thoracic EVAR.
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28377907/initial-clinical-experience-with-the-endologix-afx-unibody-stent-graft-system-for-treating-patients-with-abdominal-aortic-aneurysms-a-case-controlled-comparative-study
#9
George N Kouvelos, Petroula Nana, Vasilios Bouris, Michalis Peroulis, Aikaterini Drakou, Nikolaos Rousas, Athanasios Giannoukas, Miltiadis I Matsagkas
PURPOSE: The newly designed unibody AFX endograft system for endovascular aortic aneurysm repair is the only graft with anatomical fixation to the aortic bifurcation in comparison to most other grafts that use the infrarenal neck as the main fixation point. The aim of this study was to assess the preliminary results of the AFX stent-graft system used with infrarenal aortic component and compare them with those obtained in patients treated with a well established endograft of the same material and pure infrarenal fixation as the Gore Excluder...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28376705/a-double-nellix-and-chimney-covered-stents-challenging-treatment-of-pararenal-aortic-aneurysm
#10
Nazzareno Stella, Roberta Ficarelli, Raffaele Dito, Domitilla Brancadoro, Michele Rossi, Maurizio Taurino
A 77-year-old male patient presented with a symptomatic, 66-mm pararenal aortic aneurysm. The patient was classified as unsuitable for open surgery due to significant comorbidities. Fenestrated or branched endografts were contraindicated due to the poor iliac access (6 mm diameter). A double Nellix with chimney endovascular aneurysm sealing (ChEVAS) technique was selected to exclude the pararenal aortic aneurysm and to preserve renal arteries and the superior mesenteric artery. Technical preplanning considered the ideal proximal landing zone to be close to the origin of the almost occluded celiac trunk and the distal common iliac arteries as the ideal distal landing zone...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28366308/percutaneous-fenestrated-endovascular-aortic-graft-treatment-of-aortocaval-fistula-with-aortic-pseudoaneurysms-secondary-to%C3%A2-penetrating-trauma
#11
Sheila N Blumberg, Firas F Mussa, Thomas S Maldonado
Aortocaval fistula (ACF) is a lethal complication of aortic aneurysmal disease. Traditional treatment of ACF involves open surgical approaches to fistula ligation and repair of the great vessels, with a high mortality secondary to bleeding and cardiac compromise. We present the case of a 28-year-old man with a chronic ACF with concomitant aortic pseudoaneurysms secondary to penetrating trauma treated with a fenestrated endograft.
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28366305/off-the-shelf-multibranched-endograft-for-urgent-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#12
Enrico Gallitto, Mauro Gargiulo, Antonio Freyrie, Rodolfo Pini, Chiara Mascoli, Stefano Ancetti, Gianluca Faggioli, Andrea Stella
OBJECTIVE: The aim of this paper was to report early and midterm results of endovascular repair of urgent thoracoabdominal aortic aneurysms (TAAAs) by the off-the-shelf multibranched Zenith t-Branch endograft (Cook Medical, Bloomington, Ind). METHODS: Between January 2014 and April 2016, all patients with urgent TAAAs (asymptomatic with diameter >8 cm, symptomatic, or ruptured TAAAs) and aortoiliac anatomic feasibility underwent endovascular repair by t-Branch and were prospectively enrolled...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28360261/computed-tomography-imaging-features-in-acute-uncomplicated-stanford-type-b-aortic-dissection-predict-late-adverse-events
#13
Anna M Sailer, Sander M J van Kuijk, Patricia J Nelemans, Anne S Chin, Aya Kino, Mark Huininga, Johanna Schmidt, Gabriel Mistelbauer, Kathrin Bäumler, Peter Chiu, Michael P Fischbein, Michael D Dake, D Craig Miller, Geert Willem H Schurink, Dominik Fleischmann
BACKGROUND: Medical treatment of initially uncomplicated acute Stanford type-B aortic dissection is associated with a high rate of late adverse events. Identification of individuals who potentially benefit from preventive endografting is highly desirable. METHODS AND RESULTS: The association of computed tomography imaging features with late adverse events was retrospectively assessed in 83 patients with acute uncomplicated Stanford type-B aortic dissection, followed over a median of 850 (interquartile range 247-1824) days...
April 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28359794/multilayered-parallel-endografting-for-urgent-endovascular-repair-of-a-severely-angulated-thoracoabdominal-aortic-aneurysm
#14
Sukgu M Han, Sarah Wartman, Sung W Ham, Eric C Kuo, Vincent L Rowe, Fred A Weaver
Total endovascular repair of TAAA using branched, fenestrated stent grafts have been performed with promising midterm results. However, severe angulation of the aorta as well as close proximity of the visceral and renal artery ostia pose a significant technical challenge in designing and implanting branched, fenestrated stent grafts. Parallel grafting offers an alternative technique, allowing an urgent, or emergent total endovascular repair of symptomatic, or ruptured TAAA. We describe a technique of 4-vessel incorporation in a total endovascular repair of TAAA, using multilayered parallel endografting via bilateral femoral and unilateral brachial access...
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
#15
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/28359717/-in-situ-endografting-in-the-treatment-of-arterial-and-graft-infections
#16
REVIEW
Georges M Haidar, Taylor D Hicks, David S Strosberg, Hosam F El-Sayed, Mark G Davies
OBJECTIVE: Endografts (eg, aortic aneurysm device or covered stent) are increasingly being used to temporize or treat arterial and graft infections in inaccessible areas, in patients with compromised anatomy, or in the presence of active bleeding or rupture. This summary examines the evidence for "in situ" endografting in the treatment these conditions. METHODS: A two-level search strategy of the literature (MEDLINE, PubMed, Google Scholar, and The Cochrane Library) was performed for relevant articles listed between January 2000 and December 2015...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28349777/aortic-curvature-is-a-predictor-of-late-type-ia-endoleak-and-migration-after-endovascular-aneurysm-repair
#17
Richte C L Schuurmann, Kim van Noort, Simon P Overeem, Kenneth Ouriel, William D Jordan, Bart E Muhs, Yannick 't Mannetje, Michel Reijnen, Bram Fioole, Çağdaş Ünlü, Peter Brummel, Jean-Paul P M de Vries
PURPOSE: To evaluate the association between aortic curvature and other preoperative anatomical characteristics and late (>1 year) type Ia endoleak and endograft migration in endovascular aneurysm repair (EVAR) patients with hostile necks. METHODS: Eight high-volume EVAR centers contributed 116 EVAR patients (mean age 81±7 years; 103 men) to the study: 36 patients (mean age 82±7 years; 31 men) with endograft migration and/or type Ia endoleak diagnosed >1 year after the initial EVAR and 80 controls without early or late complications...
March 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28323232/suspected-giant-cell-aortitis-from-multiple-aortic-structural-damage-to-fatal-listeria-sepsis-a-case-report
#18
Valeria Silvestri, Giacomo Isernia
Giant cell arteritis (GCA) is an inflammatory vasculopathy affecting large- and middle-sized vessels, specifically cranial arteries derived from carotid artery. Isolated extracranial vessel involvement can occur. Interest in extravascular manifestations is recently increasing because of diffusion of sensitive and specific imaging tools such as fluorodeoxyglucose positron emission tomography computerized tomography (18 FDG PET CT). Patients have an increased relative risk of severe infection. Listeria monocytogenes infection risk is increased, and vascular system involvement and graft infection have been, although rarely, reported...
March 18, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28288887/transapical-endovascular-repair-of-thoracic-aortic-pathology
#19
Takashi Murakami, Shinsuke Nishimura, Mitsuharu Hosono, Yoshitsugu Nakamura, Etsuji Sohgawa, Yukimasa Sakai, Toshihiko Shibata
BACKGROUND: Alternative access for thoracic endovascular aortic repair (TEVAR) has been explored for patients with unsuitable femoral and iliac access, but few cases of transapical access have been described. We report our experience with transapical access for various aortic pathologies. METHODS: We reviewed 6 cases undergoing transapical access for endovascular repair of thoracic aortic pathology between December 2013 and August 2015. Five patients had an aortic arch aneurysm and 1 patient presented with Stanford type A subacute aortic dissection...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28285931/flow-and-wall-shear-stress-characterization-after-endovascular-aneurysm-repair-and-endovascular-aneurysm-sealing-in-an-infrarenal-aneurysm-model
#20
Johannes T Boersen, Erik Groot Jebbink, Michel Versluis, Cornelis H Slump, David N Ku, Jean-Paul P M de Vries, Michel M P J Reijnen
BACKGROUND: Endovascular aneurysm repair (EVAR) with a modular endograft has become the preferred treatment for abdominal aortic aneurysms. A novel concept is endovascular aneurysm sealing (EVAS), consisting of dual endoframes surrounded by polymer-filled endobags. This dual-lumen configuration is different from a bifurcation with a tapered trajectory of the flow lumen into the two limbs and may induce unfavorable flow conditions. These include low and oscillatory wall shear stress (WSS), linked to atherosclerosis, and high shear rates that may result in thrombosis...
March 9, 2017: Journal of Vascular Surgery
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