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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...
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
E Kleinspehn, F Heidemann, C A Behrendt, T Kölbel, E S Debus
BACKGROUND: The potential complications following aortic reconstruction surgery are diverse and potentially life-threatening. Besides the well known complications of open aortic repair (OAR) the spectrum of complications has been extended and shifted by the growing use of endovascular aortic repair (EVAR). AIM: The most common complications of open as well as endovascular aortic surgery are presented in a summarizing review. The focus is placed on the presentation of cardiovascular and nephrological complications, colonic ischemia, as well as aortic graft infections and graft fistulas...
July 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
J Habets, H J A Zandvoort, F L Moll, L W Bartels, E P A Vonken, J A van Herwaarden, T Leiner
OBJECTIVES/BACKGROUND: To examine the additional diagnostic value of magnetic resonance imaging (MRI) after administration of a weak albumin binding contrast agent in post-endovascular aneurysm repair (EVAR) patients with aneurysm growth with no or uncertain endoleak after computed tomography angiography (CTA). METHODS: This was a prospective diagnostic cross sectional study carried out between April 2011 and August 2013. MRI was performed in all patients with aneurysm growth≥5 mm after EVAR implantation and no or uncertain endoleak on CTA, or the inability, on CTA, to identify the source of a visible endoleak...
September 2015: European Journal of Vascular and Endovascular Surgery
Elpiniki Tsolaki, Vincenzo Gasbarro, Tiberio Rocca, Luca Traina, Sabrina Sileno, Giorgia Gastrucci, Francesco Mascoli
BACKGROUND: Abdominal aortic aneurysms (AAA) may be treated through different surgical techniques. In this endovascular era, surgery remains a mainstay in the management of this disease, especially in patients unsuitable for EVAR. The purpose of this study was to compare retrospectively the postoperative outcomes and survival rates of the transperitoneal and the retroperitoneal approach for the abdominal aortic aneurysm repair in our Unit. METHODS: A retrospective analysis of 840 consecutive patients affected by AAA who were electively admitted in our unit from 1996 to 2011 was performed...
August 2016: International Angiology: a Journal of the International Union of Angiology
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