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Caroline Caradu, Xavier Bérard, Dominique Midy, Eric Ducasse
BACKGROUND: Fenestrated (F-) endovascular aneurysm repair (EVAR)'s lack of widespread availability encouraged alternative strategies. Chimney graft (CG)-EVAR has spread when costs, manufacturing delays or anatomy preclude F-EVAR. Our objective was to evaluate CG-EVAR and F-EVAR's outcomes depending on the angulation of target renal arteries and hostility of iliac accesses to determine the potential impact of a choice made between the two techniques based upon preoperative anatomic criteria...
February 28, 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...
February 2, 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
Salvatore T Scali, Dan Neal, Vida Sollanek, Tomas Martin, Julie Sablik, Thomas S Huber, Adam W Beck
OBJECTIVE: Open surgical repair for acute aortic pathologies involving the visceral vessels is associated with morbidity and mortality rates of 40% to 70% and 30% to 60%, respectively. Due to these poor outcomes, the application of fenestrated/branched endovascular aortic repair (F/B-EVAR) has been expanded in this setting; however, durability remains unknown. The purpose of this analysis was to describe outcomes after F/B-EVAR for acute aortic disease. METHODS: A single center retrospective review of all F/B-EVARs for acute aortic disease was completed...
November 2015: Journal of Vascular Surgery
Arend F L Schinkel, Mathias Kaspar, Daniel Staub
Contrast-enhanced ultrasound (CEUS) is increasingly being used to evaluate patients with known or suspected atherosclerosis. The administration of a microbubble contrast agent in conjunction with ultrasound results in an improved image quality and provides information that cannot be assessed with standard B-mode ultrasound. CEUS is a high-resolution, noninvasive imaging modality, which is safe and may benefit patients with coronary, carotid, or aortic atherosclerosis. CEUS allows a reliable assessment of endocardial borders, left ventricular function, intracardiac thrombus and myocardial perfusion...
January 2016: International Journal of Cardiovascular Imaging
M Noel-Lamy, J Jaskolka, T F Lindsay, G D Oreopoulos, K T Tan
OBJECTIVES: Iliac branch grafts (IBGs) are a validated option for the treatment of aorto-iliac aneurysms preserving internal iliac artery (IIA) flow. IIA aneurysm (IIAA) is a relative contraindication to IBG placement. The goal of this study was to review experience in managing aorto-iliac aneurysms with concomitant IIAAs with extension of the IIA branch stent graft into the superior gluteal artery (SGA). METHODS: This retrospective study between May 2009 and November 2014 includes consecutive patients who underwent placement of an IBG (Cook, Bloomington, IN, USA) with extension of the internal iliac component of the branch stent graft into the SGA because of aneurysmal IIA (>15 mm)...
October 2015: European Journal of Vascular and Endovascular Surgery
F Bastos Gonçalves
No abstract text is available yet for this article.
September 2015: European Journal of Vascular and Endovascular Surgery
R Shahverdyan, M P Majd, R Thul, N Braun, M Gawenda, J Brunkwall
OBJECTIVE: To compare the results of elective open surgical repair (OSR) and total endovascular repair of juxtarenal aortic aneurysms (JAA), with either the Cook Zenith or the Vascutek Anaconda fenestrated stent grafts (F-EVAR) in a university hospital setting. PATIENTS AND METHODS: Between April 1999 and July 2014, of 926 patients with an abdominal aortic aneurysm, 69 were juxtarenal, where 34 had an elective OSR and 35 had F-EVAR. A post-operative rise of baseline creatinine by >50% and/or deterioration of estimated glomerular filtration rate by 25% were defined as renal failure...
October 2015: European Journal of Vascular and Endovascular Surgery
M Michel, J-P Becquemin, M-C Clément, J Marzelle, C Quelen, I Durand-Zaleski
OBJECTIVE: To compare 30 day outcomes and costs of fenestrated and branched stent grafts (f/b EVAR) and open surgery (OSR) for the treatment of complex abdominal aortic aneurysms (AAA) and thoraco-abdominal aortic aneurysms (TAAA). METHODS: The multicenter prospective registry WINDOW was set up to evaluate f/b EVAR in high risk patients with para/juxtarenal AAA, and infradiaphragmatic and supradiaphragmatic TAAA. A control group of patients treated by OSR was extracted from the national hospital discharge database...
August 2015: European Journal of Vascular and Endovascular Surgery
Kyriakos Oikonomou, Athanasios Katsargyris, Clayton J Brinster, Hermann Renner, Wolfgang Ritter, Eric L G Verhoeven
PURPOSE: To present retrograde target vessel catheterization as a bailout technique in fenestrated and branched endografting (F/B-EVAR). METHODS: Between November 2003 and November 2014, 11 (1.6%) of 671 consecutive patients with juxtarenal, suprarenal, and thoracoabdominal aortic aneurysms required retrograde target vessel access as a bailout measure during F/B-EVAR due to failure of an antegrade approach. The target vessels involved the left renal artery (LRA) in 6 patients, the celiac artery (CA) in 3 patients, the right renal artery (RRA) in 1 patient, and both renal arteries in 1 patient...
August 2015: Journal of Endovascular Therapy
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