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https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#1
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28638171/3d-printed-abdominal-aortic-aneurysm-phantom-for-image-guided-surgical-planning-with-a-patient-specific-fenestrated-endovascular-graft-system
#2
Karen M Meess, Richard L Izzo, Maciej L Dryjski, Richard E Curl, Linda M Harris, Michael Springer, Adnan H Siddiqui, Stephen Rudin, Ciprian N Ionita
Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28633258/stepwise-total-aortic-repairs-with-fenestrated-endografts-in-a-patient-with-loeys-dietz-syndrome
#3
Kenichi Hashizume, Hideyuki Shimizu, Masanori Honda, Shinya Inoue, Hidenobu Takaki, Kanako Hayashi, Hiroaki Kaneyama
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder (CTD) caused by mutations in the gene encoding transforming growth factor-β receptors Ⅰ and Ⅱ. Patients with LDS manifest spontaneous aneurysms and dissections of the aorta and peripheral artery. We report a successful treatment with a hybrid endovascular repair for a rapidly expanding thoracoabdominal aneurysm in a 41-year-old woman affected by LDS. To overcome the difficulties of anatomical and surgical repair, we applied an original strategy using surgeon-modified fenestrated endografts...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28616352/aortic-polyaneurysmal-disease-case-report
#4
Lucas Alvarez García, Paula Vidal Fernández, Miguel Felipe García Gimeno, Miguel Angel González Arranz, Maria Emma González González, Diego López García, Salvador Tagarro Villalba, Santiago Rodríguez Camarero
We report a 78-year-old man who presents progression of his aneurysmatic pathology with previous abdominal infrarenal aortic surgery 20 years later. The computed tomography (CT) scan showed proximal degeneration of the infrarenal aorta, left iliac aneurysm and a new descending thoracic aneurysm close to the aortic arch. The surgical treatment was staged in two times due to the evolution of the aneurysm measures. First, the thoracic and the infrarenal aneurysms were covered each one with endoprosthesis. Four years later the iliac disease was solved with a branched specific iliac endograft...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602624/durability-of-a-low-profile-stent-graft-for-thoracic-endovascular-aneurysm-repair
#5
Giovanni F Torsello, Mirjam Inchingolo, Martin Austermann, Giovanni B Torsello, Giuseppe Panuccio, Theodosios Bisdas
OBJECTIVE: The introduction of lower profile endografts expanded the application of aortic endovascular repair. However, evidence about their durability is still scarce. The objective of this study was to assess longer term durability of the Zenith Alpha Thoracic Stent Graft (Cook Inc, Bloomington, Ind) after thoracic endovascular aortic repair. METHODS: Prospectively collected data of all patients treated for thoracic aortic aneurysms or penetrating aortic ulcers and having computed tomography angiography-based follow-up of ≥12 months were retrospectively analyzed...
June 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28602623/comparison-of-outcomes-for-short-neck-and-juxtarenal-aortic-aneurysms-treated-with-the-nellix-endograft-versus-conventional-endovascular-aneurysm-sealing
#6
Daniele Psacharopulo, Michelangelo Ferri, Emanuele Ferrero, Sandeep S Bahia, Andrea Viazzo, Alberto Pecchio, Fulvio Ricceri, Franco Nessi
OBJECTIVE: The objective of this study was to evaluate the results of the off-label use of the Nellix endograft (Endologix, Irvine, Calif) for the treatment of short-neck aneurysms and juxtarenal aortic aneurysms (JAAs) compared with the outcomes of patients with infrarenal abdominal aortic aneurysms treated in accordance with the manufacturer's instructions for use. METHODS: Data available from patients treated with the Nellix endograft from September 2013 to January 2016 were reviewed to create a case-control analysis (1:2)...
June 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28602578/femoral-arterial-haemostasis-using-an-anchored-collagen-plug-after-percutaneous-evar-with-an-ultra-low-profile-device-prospective-audit-of-an-evolving-post-close-technique
#7
A Chaudhuri
OBJECTIVE: To present an audit of a successful "post-close" haemostatic technique using the Angio-Seal VIP vascular closure device (VCD) after percutaneous endovascular aneurysm repair (p-EVAR) using an ultra-low profile (ULP) device. METHODS: Thirty patients underwent EVAR using the Ovation device, of which 26 procedures were totally percutaneous. Data including patient habitus, procedural details, number of VCDs deployed including use of the double wire approach, and technical success/complications were prospectively recorded...
June 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28602115/total-endovascular-treatment-of-aortic-arch-disease-using-an-arch-endograft-with-3-inner-branches
#8
Rafaëlle Spear, Rachel E Clough, Dominique Fabre, Blayne Roeder, Adrien Hertault, Teresa Martin Gonzalez, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
PURPOSE: To report early experience with a new endovascular graft developed for aortic arch aneurysm repair in patients unfit for open surgery. CASE REPORT: Three consecutive men (62, 74, and 69 years old) at high risk for open repair were treated for postdissection aortic arch aneurysms using a custom-made 3 inner branched endovascular graft. The 2 proximal branches are antegrade and perfuse the innominate artery and the left common carotid artery; the third branch is retrograde and perfuses the left subclavian artery...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28602114/combination-of-chimneys-and-fenestrated-endografts-in-the-treatment-of-complex-aortic-aneurysms
#9
Caroline Caradu, Julien Morin, Dominique Midy, Sandro Lepidi, Eric Ducasse
PURPOSE: To present early results of fenestrated endovascular aneurysm repair (FEVAR) combined with chimney grafts in a high-volume center. METHODS: From July 2011 to July 2016, 45 patients (mean age 73.0±8.8 years; 39 men) with complex aneurysms who were poor candidates for open repair and anatomically ineligible for standard or custom-made FEVAR were treated with chimney FEVAR (chFEVAR). Eight (18%) cases were treated in emergency. In all, 130 target vessels (2...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28597730/early-results-of-the-bolton-treovance-endograft-in-the-treatment-of-abdominal-aortic-aneurysms
#10
Efstratios Georgakarakos, George Pitoulias, Nikolaos Schoretsanitis, Christos Argyriou, Dimitrios M Mavros, Miltos K Lazarides, George S Georgiadis
PURPOSE: To present early results with the Treovance aortic stent-graft in the treatment of abdominal aortic aneurysms (AAAs). METHODS: Between October 2013 and January 2016, 35 consecutive AAA patients (mean age 74±7.7 years; 32 men) were treated with Treovance. The maximum diameter of the treated AAA was 60±9 cm. Nine (25%) patients presented with concomitant iliac aneurysms. Seven (20%) AAAs had infrarenal neck angulation >60°. The infrarenal neck length and diameter were 21...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28597717/physician-modified-thoracic-stent-grafts-for-the-treatment-of-aortic-arch-lesions
#11
Ludovic Canaud, Toshio Baba, Thomas Gandet, Kouhei Narayama, Baris Ata Ozdemir, Tsuyoshi Shibata, Pierre Alric, Kiyofumi Morishita
PURPOSE: To evaluate outcomes of physician-modified thoracic stent-grafts for the treatment of aortic arch aneurysms. METHODS: A retrospective dual-center analysis was performed involving 36 patients (mean age 74.7±9 years, range 58-91; 27 men) with an aortic arch lesion who were treated between November 2013 and June 2016 using physician-modified thoracic stent-grafts. Half of the patients had a degenerative aneurysm; the remainder had type B dissection (n=9), traumatic transection (n=3), type Ia endoleak after previous endografting (n=5), or aortoesophageal fistula (n=1)...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#12
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28587564/how-to-confirm-catheterization-of-inner-branches-in-aortic-endografting-the-universal-flush-test
#13
Beatrice Fiorucci, Nikolaos Tsilimparis, Fiona Rohlffs, Franziska Heidemann, Eike Sebastian Debus, Tilo Kölbel
PURPOSE: To describe a quick, simple, and reliable technique to confirm successful catheterization of a branched thoracic endograft's inner branch. TECHNIQUE: Accurate cannulation of inner branches can be verified through insertion and mild retraction of a Universal Flush angiographic catheter, whose tip hooks the branch and slightly opens. CONCLUSION: The use of an angiographic catheter with a curved tip is a safe and easy procedure that can be adopted to check the correct position inside the branch of an endograft designed for treatment of the aortic arch...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28583736/partial-distal-deployment-for-precise-placement-of-the-gore-thoracic-endoprosthesis
#14
Gregory A Stanley
The GORE TAG Thoracic Endoprosthesis (TAG) device (W. L. Gore & Associates, Flagstaff, Ariz) and the GORE Conformable TAG Thoracic Endoprosthesis (CTAG) are commonly implanted and effective stent grafts for use during thoracic endovascular aortic repair. Precise placement of the endograft is paramount during thoracic endovascular aortic repair, but like all thoracic stent grafts, maldeployment with inaccurate landing has been reported. The partial distal deployment technique describes an alteration of the TAG and CTAG deployment mechanism to allow isolated deployment of the distal half of the graft, which provides stability during deployment...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28582035/design-and-clinical-considerations-for-endovascular-stent-grafts
#15
REVIEW
Alexis Powell, Vikram S Kashyap
Endovascular treatment for aortic abnormality is an excellent alternative option for patients who are not good candidates for conventional open surgery. Although the technique of placing endovascular stent grafts has evolved since the first grafts, the basic principles remain the same. Use of endografts is limited by anatomic criteria, and advances in graft design have allowed for more widespread use for a broader patient range. The most important limitations to overcome are achieving high-quality aortic neck "healthy" landing zone, smaller-diameter delivery systems, and endografts that allow for more angled aortic necks...
July 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28566059/the-effect-of-endograft-device-on-patient-outcomes-in-endovascular-repair-of-ruptured-abdominal-aortic-aneurysms
#16
Vinay Kansal, Sudhir Nagpal, Prasad Jetty
Objective Endovascular aneurysm repair for ruptured abdominal aortic aneurysm is being increasingly applied as the intervention of choice. The purpose of this study was to determine whether survival and reintervention rates after ruptured abdominal aortic aneurysm vary between endograft devices. Methods This cohort study identified all ruptured abdominal aortic aneurysms performed at The Ottawa Hospital from January 1999 to May 2015. Data collected included patient demographics, stability index at presentation, adherence to device instructions for use, endoleaks, reinterventions, and mortality...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28559176/results-from-multiple-prospective-single-center-clinical-trials-of-the-off-the-shelf-p-branch-fenestrated-stent-graft
#17
Mark A Farber, Matthew J Eagleton, Tara M Mastracci, James F McKinsey, Raghuveer Vallabhaneni, Björn Sonesson, Nuno Dias, Timothy Resch
OBJECTIVE: The purpose of this study was to report prospective data of an off-the-shelf fenestrated endograft (Zenith p-Branch; Cook Medical, Bloomington, Ind) from four centers for the treatment of patients with pararenal abdominal aortic aneurysms. METHODS: Data were combined from four single-center investigational studies conducted in the United States and Europe. The p-Branch endograft consists of a proximal off-the-shelf component incorporating a scallop for the celiac artery, a superior mesenteric artery fenestration, and two conical pivot fenestrations to preserve flow to the renal vessels...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28559175/rescue-of-failed-endovascular-aortic-aneurysm-repair-using-the-fenestrated-anaconda-device
#18
Jürgen Falkensammer, Fadi Taher, Miriam Uhlmann, Kornelia Hirsch, Johannes Strassegger, Afshin Assadian
OBJECTIVE: Endovascular aortic aneurysm repair (EVAR) with a fenestrated device (FEVAR) allows an extension of the proximal sealing zone above the renal arteries to an adequate, healthier segment of the aorta. This feature makes FEVAR an option to treat patients with a diseased aortic neck or type Ia endoleak after EVAR. The aim of this investigation was to present a single-center experience with FEVAR for patients with an abdominal aortic endograft in situ compared with primary FEVAR...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28552169/large-single-center-databases-and-the-evolution-of-endovascular-therapy-for-complex-aortic-aneurysms
#19
Matthew J Eagleton, Behzad Farivar, Agenor Dias
BACKGROUND: Fenestrated and branched endograft repair of complex aortic disease has revolutionized the approach to treatment of this life-threatening problem. Several sites have developed long-standing programs evaluating the application and outcomes of this technology. These reports are based on the development of large, single-center databases. These centers have helped to pioneer the evolution of this approach, and their assessments have led to significant improvements and identified areas that require improvement in the ensuing years...
May 25, 2017: Surgery
https://www.readbyqxmd.com/read/28550589/carbon-dioxide-co2-angiography-as-an-option-for-endovascular-abdominal-aortic-aneurysm-repair-evar-in-patients-with-chronic-kidney-disease-ckd
#20
Chiara De Angelis, Francesco Sardanelli, Matteo Perego, Marco Alì, Francesco Casilli, Luigi Inglese, Giovanni Mauri
To assess feasibility, efficacy and safety of carbon dioxide (CO2) digital subtraction angiography (DSA) to guide endovascular aneurysm repair (EVAR) in a cohort of patients with chronic kidney disease (CKD). After Ethical Committee approval, the records of 13 patients (all male, mean age 74.6 ± 8.0 years) with CKD, who underwent EVAR to exclude an abdominal aortic aneurysm (AAA) under CO2 angiography guidance, were reviewed. The AAA to be excluded had a mean diameter of 52.0 ± 8.0 mm. CO2 angiography was performed by automatic (n = 7) or hand (n = 6) injection...
May 27, 2017: International Journal of Cardiovascular Imaging
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