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José Oliveiar-Pinto, Nilo Mosquera, José Vidoedo, Sérgio Moreira-Sampaio, José Teixeira
INTRODUCTION: Prevalence of Abdominal Aortic Aneurysm (AAA) with concomitant malignancy rounds 3-13%. Considering only urological neoplasms the prevalence is around 3.6%. Survival at 5 years of bladder carcinoma without extravesical invasion (stage II) rounds 63%. Endovascular Aneurysm Repair (EVAR), due to its minimally invasive profile, is an option for treatment of AAA prior to urological surgery as it does not require laparotomy not conditioning the delay of oncologic surgery. METHODS: Male, 62 years old...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Satinderjit Locham, Muhammad Faateh, Hanaa Dakour Aridi, Besma Nejim, Mahmoud Malas
BACKGROUND: Prior studies have shown that octogenarians have a higher risk of mortality compared to non-octogenarians undergoing open (OAR) and endovascular (EVAR) abdominal aortic aneurysm (AAA) repair. Fenestrated-endovascular repair (F-EVAR) was approved by Food and Drug Administration (FDA) in 2012 and has been populated as a less invasive approach to treat patients with suboptimal neck anatomy with favorable outcomes compared to traditional OAR. The aim of the study is to compare 30-day outcomes of F-EVAR vs...
April 17, 2018: Annals of Vascular Surgery
Krister Liungman, Kevin Mani, Anders Wanhainen, Linus Bosaeus, Mario Lachat
OBJECTIVE: A new endovascular tool, the Liungman Guidewire Fixator, has been developed to simplify endovascular treatment in complex aortic aneurysms. The device has been extensively tested in bench models and animal trials. To verify the safety and functionality demonstrated in the porcine model, the device was tested in ten patients undergoing endovascular aortic repair (EVAR) or fenestrated endovascular aortic repair (f-EVAR) treatment for abdominal aortic aneurysm. METHODS: The Liungman Guidewire Fixator consists of a braided stent-like, cylindrical structure with conical ends and a central channel for a 0...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Konstantinos Spanos, George Α Antoniou, Athanasios D Giannoukas, Fiona Rohlffs, Nikolaos Tsilimparis, Sebastian E Debus, Tilo Kölbel
BACKGROUND: The aim of this study was to evaluate the long term durability of fenestrated endovascular aortic aneurysm repair (F-EVAR) of juxta-renal aortic aneurysms (JAAAs) in terms of mortality, target visceral vessel (TVV) patency and Reintervention rates. EVIDENCE ACQUISITION: A systematic review and meta-analysis was performed. MEDLINE, CENTRAL, and Cochrane databases were searched with PRISMA methodology for studies reporting on F-EVAR of JAAA presenting follow-up >36 months...
April 2018: Journal of Cardiovascular Surgery
G Tinelli, A Hertault, T Martin Gonzalez, R Spear, R Azzaoui, J Sobocinski, R E Clough, S Haulon
OBJECTIVE: The aim of this study was to evaluate a new 3D Workstation workflow (EVAR Assist, Advantage Windows, GE Healthcare, Chalfont, UK) (EA-AW) designed to simplify complex EVAR planning. PATIENTS AND METHODS: All pre-operative computed tomography (CT) scans of patients who underwent repair at our institution of a complex aortic aneurysm using fenestrated endovascular repair (f-EVAR) between January and September 2014, were reviewed. For each patient, imaging analysis (12 measures: aortic diameters and length and "clock position" of visceral artery) was performed on two different workstations: Aquarius (TeraRecon, San Mateo, CA, USA) and EA-AW...
June 2017: European Review for Medical and Pharmacological Sciences
Dominique Midy, Jean-Pierre Becquemin, Claude Mialhe, Nicolas Frisch, Robert Martinez, Caroline Caradu
BACKGROUND: Most of the experience on fenestrated endovascular aneurysm repair involves the custom-made Zenith® endograft (Cook). The fenestrated Anaconda® endograft (Vascutek) was introduced with the potential advantages of complete repositioning and lack of stent material on the main aortic body for more versatility. However, few data are available. Our objective was to assess its mid-term results in the treatment of complex aortic aneurysms. METHODS: Consecutive patients treated with the custom-made fenestrated Anaconda endograft in France and the Principality of Monaco, from December 2010 to October 2015, were included...
August 2017: Annals of Vascular Surgery
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Hiroki Ohta, Soichirou Fukushima, Naoki Toya, Masayuki Hara
BACKGROUND: In this single-center study, we assessed the clinical outcomes of fenestrated endovascular aortic repair (f-EVAR) and branched EVAR on morbidity and mortality during total endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between July 2006 and June 2015, elective f-EVAR and multibranched EVAR (t-Branch) for TAAAs were performed in 99 patients at our institution (Crawford classification types I [7], II [13], III [6], IV [55], and V [18])...
October 2017: Annals of Vascular Surgery
Caroline Caradu, Xavier Bérard, Dominique Midy, Eric Ducasse
BACKGROUND: The lack of widespread availability of Fenestrated endovascular aneurysm repair (F-EVAR) encouraged alternative strategies. Hence, Chimney graft (CG)-EVAR spread when costs, manufacturing delays, or anatomy preclude F-EVAR. Our objective is to evaluate CG- and F-EVAR outcomes depending on the angulation of target renal arteries and hostility of iliac accesses in order to determine the potential impact of a choice made between both techniques on the basis of preoperative anatomic criteria...
August 2017: Annals of Vascular Surgery
Caroline Caradu, Julien Morin, Mathieu Poirier, Dominique Midy, Eric Ducasse
BACKGROUND: With approval of on-label fenestrated (F-) endovascular aortic repair (EVAR), concerns regarding long-term patency and endoleaks (ELs) after chimney graft (CG)-EVAR were raised. To add supportive data on the value of this technique, we chose to report the midterm results of CG-EVAR in a single center with standardized methods and to compare them to F-EVAR. METHODS: A retrospective analysis of prospectively gathered data from January 2010 to January 2015 was conducted, and patients with excessive comorbidities for open repair treated by CG-EVAR or F-EVAR were included...
April 2017: Annals of Vascular Surgery
Caroline Caradu, Xavier Berard, Gérard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: Anatomical constrains, high price and manufacturing delay restrict fenestrated (F)-endovascular aortic repair (EVAR) to elective patients in specialized centers. Chimney graft (CG)-EVAR offers an alternative but uncertainties remain over target vessel's patency and type Ia endoleaks (ELs). METHODS: We reviewed the literature reporting F-EVAR and CG-EVAR for juxtarenal aneurysms between January 2005 and July 2016. RESULTS: Fifteen studies on F-EVAR, 8 on CG-EVAR and 5 on both techniques were included; 1748 F-EVAR patients (3993 target vessels) vs 757 (1158 target vessels, 13% symptomatic and 7% ruptured)...
October 27, 2016: Journal of Cardiovascular Surgery
R Shahverdyan, D Gray, M Gawenda, J Brunkwall
OBJECTIVE: Fenestrated endovascular aneurysm repair (F-EVAR) has increased the number of patients with aneurysmal disease and a short or no existing neck being eligible for endovascular treatment. The aim of the study is to report experience using the Anaconda fenestrated device with special emphasis on target vessel patency and pitfalls with the device. METHODS: Between 2011 and 2016, 48 F-EVAR procedures were performed in 37 males and 11 females under general anaesthesia using the Anaconda custom made device (CMD)...
October 2016: European Journal of Vascular and Endovascular Surgery
Andrés Reyes, Konstantinos P Donas, Georgios Pitoulias, Martin Austermann, Claudio Gandarias, Giovanni Torsello
PURPOSE: To evaluate the totally endovascular techniques for treating complex pararenal aortic aneurysms after open repair of abdominal aortic aneurysm. METHODS: This retrospective study involved 34 men (mean age 74 years) with pararenal aortic aneurysms (22 pseudoaneurysms and 12 para-anastomotic aneurysms) that developed a median 11 years (range 4-22) after the primary surgical reconstruction. The median infrarenal neck length was 2 mm (range 0-9). Total endovascular aneurysm repair (EVAR) included the use of fenestrated (f-EVAR; n=17), branched (b-EVAR; n=11), combined f-EVAR/b-EVAR (n=1), and chimney (ch-EVAR; n=4) grafts and the "sandwich" technique (n=1)...
August 2016: Journal of Endovascular Therapy
Yue Li, Zhongzhou Hu, Chujie Bai, Jie Liu, Tao Zhang, Yangyang Ge, Shaoliang Luan, Wei Guo
Juxtarenal aortic aneurysms (JAA) account for approximately 15% of abdominal aortic aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (CH-EVAR) are both effective methods to treat JAAs, but the comparative effectiveness of these treatment modalities is unclear. We searched the PubMed, Medline, Embase, and Cochrane databases to identify English language articles published between January 2005 and September 2013 on management of JAA with fenestrated and chimney techniques to conduct a systematic review to compare outcomes of patients with juxtarenal aortic aneurysm (JAA) treated with the two techniques...
February 12, 2016: Scientific Reports
Athanasios N Saratzis, Michael F Bath, Seamus C Harrison, Robert D Sayers, Matthew J Bown
PURPOSE: To investigate the impact of fenestrated endovascular aneurysm repair (fEVAR) on renal function perioperatively and at midterm. METHODS: A case-controlled study was performed involving 58 patients (mean age 75±7 years; 51 men) who underwent elective fEVAR for a juxtarenal or short-necked abdominal aortic aneurysm (AAA) matched on age, sex, smoking, diabetes, and baseline estimated glomerular filtration rate (eGFR) with a contemporaneous group undergoing open aneurysm repair (OAR) for the same indications...
December 2015: Journal of Endovascular Therapy
Chen Duan, Senhao Jia, Jie Liu, Wei Guo, Xiaoping Liu
OBJECTIVE: To investigate the outcomes in overweight and obesity patients with abdominal aortic aneurysm (AAA) treated with elective open or endovascular repair (EVAR). METHODS: The clinical data of 52 patients with AAA treated by EVAR (EVAR group, n=17) and conventional surgical repair (open group, n=54) were analyzed retrospectively. Overweight was defined as a body mass index (BMI) between 24 kg/m2 and 28 kg/m2, obesity was defined as a BMI 28 kg/m2. Patients' conditions, operative time, blood loss, function recovery and complications were compared...
June 1, 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Nelson F G Oliveira, João A Castro, José D Martins, Anita Quintas, Sérgio Laranjo, Hugo Valentim, Fátima Pinto, Luís M Capitão
UNLABELLED: Introduction Thoracic endovascular aneurysm repair has been employed to treat late complications after aortic coarctation correction. However, its use in children has seldomly been reported. Case report We present the case of a 15-year-old child who presented with a ruptured aneurysm of the descending aorta complicated later by an aortic-oesophageal fistula following aortic coarctation stenting that was managed with multiple bridging endovascular interventions until a definitive repair was performed...
June 2016: Cardiology in the Young
F Biancari, J Mäkelä, T Juvonen, M Venermo
Type II endoleak is a common condition occurring after endovascular repair of abdominal aortic aneurysms (EVAR), and may result in aneurysm sac growth and/or rupture in a small number of patients. A prophylactic strategy of inferior mesenteric artery (IMA) embolization before EVAR has been advocated, however, the benefits of this strategy are controversial. A clinical vignette allows the authors to summarize the available data about this issue and discuss the possible benefits and risks of prophylactic IMA embolization before EVAR...
November 2015: European Journal of Vascular and Endovascular Surgery
Lucas R Beffa, Gregory F Petroski, Robin L Kruse, Todd R Vogel
Although many trials have evaluated abdominal aortic aneurysm (AAA) repair, the impact of these procedures on the functional status of frail elderly patients is not well-described. The effects of elective open AAA repair (OAR) and endovascular AAA repair (EVAR) and comorbidities were evaluated for their impact on functional trajectories after discharge. Medicare inpatient claims were linked with nursing home assessment data to identify elective admissions for OAR and EVAR. A functional score (range, 0-28; higher scores indicate greater impairment) was calculated before and after interventions...
September 2015: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
R F F van den Haak, B C Hamans, K Zuurmond, B A N Verhoeven, O H J Koning
OBJECTIVE/BACKGROUND: To prospectively quantify radiation dose change in aortoiliac endovascular procedures in the hybrid operating room (OR) for patients and medical staff with a novel X-ray imaging technology (ClarityIQ technology), and to assess whether procedure or fluoroscopy time or dose of iodinated contrast was affected. METHODS: A prospective study including 138 patients was performed to compare radiation dose before and after installation of a novel X-ray imaging technology...
October 2015: European Journal of Vascular and Endovascular Surgery
L Cassagnes, R Pérignon, F Amokrane, A Petermann, T Bécaud, B Saint-Lebes, P Chabrot, H Rousseau, L Boyer
Endoleaks have been referred to as the "Achilles heel" of endovascular aortic aneurysm repair (EVAR) and are the most common complication of this procedure. An endoleak can maintain a high systemic blood pressure within the aneurysm sac, potentially leading to rupture. Follow-up is therefore mandatory to detect and classify possible endoleaks. Computed tomography (CT) remains the gold standard for follow-up, but provides no hemodynamic information on endoleaks and has the disadvantages of exposing patients to iodine contrast and X-ray radiation...
January 2016: Diagnostic and Interventional Imaging
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