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Zilun Li, Henghui Yin, Mian Wang, Ridong Wu, Chenshu Liu, Chen Yao, Guangqi Chang
PURPOSE: To report the use of the octopus endograft technique to treat a patient with a ruptured thoracoabdominal aortic aneurysm (TAAA). CASE REPORT: A 46-year-old man was diagnosed with a contained rupture of a 9-cm type V TAAA. The presence of an occluded superior mesenteric artery (SMA), a stenotic celiac trunk, an enlarged inferior mesenteric artery (IMA), and rich collaterals with the SMA and celiac trunk made endovascular repair with the octopus endograft technique appear feasible...
April 2018: Journal of Endovascular Therapy
Rami O Tadros, Alex Sher, Martin Kang, Ageliki Vouyouka, Windsor Ting, Daniel Han, Michael Marin, Peter Faries
OBJECTIVE: The ideal treatment option for patients with complex aneurysm morphology remains highly debated. The aim of this study was to investigate the impact of endovascular aneurysm repair (EVAR) with active fixation on outcomes in patients with complex aneurysm morphology. METHODS: There were 340 consecutive patients who underwent EVAR using active fixation devices, 234 with active infrarenal fixation (AIF; Gore Excluder; W. L. Gore & Associates, Flagstaff, Ariz) and 106 with active suprarenal fixation (ASF; 85 Medtronic Endurant [Medtronic, Santa Rosa, Calif] and 21 Cook Zenith [Cook Medical, Bloomington, Ind])...
March 13, 2018: Journal of Vascular Surgery
Hanfei Tang, Xiao Tang, Weiguo Fu, Jianjun Luo, Zhenyu Shi, Lixin Wang, Fei Liu, Daqiao Guo
OBJECTIVE: Coil embolization is one of the most common endovascular approaches to treatment of renal artery aneurysms (RAAs). The purpose of this retrospective study was to compare complications, mortality, and morbidity associated with sac packing, coil trapping, and inflow occlusion. METHODS: The records of all patients with RAAs treated with coil embolization at our center from June 2003 to May 2017 were retrospectively reviewed. Demographics of the patients, aneurysm characteristics, management strategies, perioperative and long-term outcomes, and complications were analyzed...
March 12, 2018: Journal of Vascular Surgery
Simon P Overeem, Esmé J Donselaar, Jorrit T Boersen, Erik Groot Jebbink, Cornelis H Slump, Jean-Paul P M de Vries, Michel M P J Reijnen
PURPOSE: To assess the dynamic behavior of chimney grafts during the cardiac cycle. METHODS: Three chimney endovascular aneurysm repair (EVAR) stent-graft configurations (Endurant and Advanta V12, Endurant and Viabahn, and Endurant and BeGraft) were placed in silicone aneurysm models and subjected to physiologic flow. Electrocardiography (ECG)-gated contrast-enhanced computed tomography was used to visualize geometric changes during the cardiac cycle. Endograft and chimney graft surface, gutter volume, chimney graft angulation over the center lumen line, and the D-ratio (the ratio between the lengths of the major and minor axes) were independently assessed by 2 observers at 10 time points in the cardiac cycle...
March 1, 2018: Journal of Endovascular Therapy
Xin Yang, Xiang-Chen Dai, Jie-Chang Zhu, Yu-Dong Luo, Hai-Lun Fan, Zhou Feng, Yi-Wei Zhang, Fan-Guo Hu
Despite being widely used for several years, the endovascular aortic repair (EVAR) of a thoracoabdominal aneurysm (TAAA) remains challenging, particularly the revascularization of the abdominal aortic visceral branches. A 66-year-old male was admitted to hospital with abdominal bloating and pain. Computed tomographic angiography (CTA) confirmed a Crawford type III TAAA from the distal descending aorta to the suprarenal abdominal aorta that involved the celiac axis, accompanied with an occlusion of the left subclavian artery...
January 1, 2018: Journal of International Medical Research
Hyun-Chel Joo, Seung-Hyun Lee, Byung-Chul Chang, Sak Lee, Kyung-Jong Yoo, Young-Nam Youn
BACKGROUND: With the increasing use of endovascular aortic repair, secondary interventions after aortic stent grafting remain a concern. We retrospectively reviewed open conversion cases with complications following endovascular abdominal aortic repair (EVAR). METHODS: EVAR due to infra-renal abdominal aortic aneurysm (AAA) was performed in 566 patients between January 1994 and May 2015. A retrospective review of EVAR requiring late open conversion (>1 month after implant) was conducted...
March 12, 2018: Journal of Cardiovascular Surgery
Thomas S Maldonado, Nilo J Mosquera, Peter Lin, Raffaello Bellosta, Michael Barfield, Albeir Moussa, Robert Rhee, Marc Schermerhorn, Jeffrey Weinberger, Marald Wikkeling, Jan Heyligers, Frank J Veith, Ross Milner, Michel P J Reijnen
OBJECTIVE: The Gore Iliac Branch Endoprosthesis (IBE; W. L. Gore & Associates, Flagstaff, Ariz) has recently been approved by the Food and Drug Administration for treatment of common iliac artery (CIA) aneurysms. Despite early excellent results in clinical trial, none of 63 patients were treated for bilateral iliac aneurysms. The goal of this study was to examine real-world experience using the Gore IBE for bilateral CIA aneurysms. METHODS: A retrospective review of an international multicenter (16 U...
March 8, 2018: Journal of Vascular Surgery
Martijn L Dijkstra, Tryfon Vainas, Clark J Zeebregts, Lotty Hooft, Maarten J van der Laan
INTRODUCTION: The incidence of spinal cord ischaemia (SCI) and subsequent paraplegia after thoracic endovascular aneurysm repair (TEVAR) and thoraco-abdominal endovascular aneurysm repair is estimated to be between 2.5% and 8%. The aim of this review is to provide an overview of SCI preventive strategies in TEVAR and thoraco-abdominal repair and recommend an optimal strategy. METHODS: Medline, Embase, and the Cochrane Library were searched for studies on TEVAR, thoraco-abdominal endovascular repair, and the use of SCI preventive measures...
March 7, 2018: European Journal of Vascular and Endovascular Surgery
Shernaz S Dossabhoy, Jessica P Simons, Kyle R Diamond, Julie M Flahive, Francesco A Aiello, Edward J Arous, Louis M Messina, Andres Schanzer
OBJECTIVE: Reinterventions after fenestrated or branched endovascular aneurysm repair (F/B-EVAR) are sometimes necessary to maintain aneurysm exclusion or endograft and target artery patency. These reinterventions are nontrivial, potentially associated with morbidity, mortality, and resource utilization. Whereas rates, types, and outcomes of reintervention after infrarenal EVAR have been well described, they have not been well described for F/B-EVAR. We sought to characterize the morbidity, mortality, and resource utilization due to reinterventions after F/B-EVAR...
March 6, 2018: Journal of Vascular Surgery
C Mascoli, G L Faggioli, E Gallitto, V Vento, R Pini, A Vacirca, G Indelicato, M Gargiulo, A Stella
INTRODUCTION: Endovascular Aortic Repair (EVAR) is presently the preferred treatment for abdominal aortic aneurysm; however, it requires the injection of contrast medium, which can hamper the renal function. Other non-toxic agents, such as carbon dioxide (CO2 ) have been sporadically tested in this setting with uncertain results. Aim of the study is to investigate the efficacy of a new standardized CO2 injection method in standard EVAR procedures. METHODS: Between August and October 2016, 31 consecutive patients (median age 76...
March 6, 2018: Annals of Vascular Surgery
Neil P Reddy, Sung Wan Ham, Fred A Weaver, Vincent L Rowe, Kenneth R Ziegler, Sukgu M Han
Endovascular aneurysm repair has become the first-line treatment modality for infrarenal aortic aneurysms. However, obtaining successful long-term results frequently require re-interventions. Particularly, delayed type 1a endoleaks pose a challenging problem, as they are often associated with proximal extension of the aneurysmal process to juxta or para-renal aortic segments. We describe two remedial techniques to repair delayed type 1a endoleak by extending the seal zone to the suprarenal aorta, while incorporating the renal arteries...
March 5, 2018: Annals of Vascular Surgery
Shunichiro Fujioka, Shigeru Hosaka, Hayato Morimura, Ken Chen, Zhi Chao Wang, Koji Toguchi, Shoji Fukuda, Koki Takizawa, Hiroshi Osawa
Objective : Patients of aorto-iliac aneurysms who undergo endovascular aortic repair (EVAR) require internal iliac artery (IIA) occlusion with coil embolization and its coverage with the stent graft to prevent type II endoleak after extending the endograft into the external iliac artery. However, it has become well recognized that IIA occlusion cause buttock claudication and other various sequelae due to pelvic ischemia. We retrospectively analyzed IIA occlusion outcomes. Methods : From October 2008 to February 2015, 71 patients with aorto-iliac aneurysms underwent IIA occlusion prior to EVAR...
December 25, 2017: Annals of Vascular Diseases
Atsushi Aoki, Kazuto Maruta, Norifumi Hosaka, Tadashi Omoto, Tomoaki Masuda, Takehiko Gokan
Objectives : Aneurysm shrinkage after EVAR is the strong factor of favorable outcomes after endovascular abdominal aortic aneurysm repair (EVAR), and type II endoleaks is the risk factor of no aneurysm shrinkage or aneurysm enlargement in the long term. In this study, we evaluate the aortic side branches relate to early postoperative type II endoleak, and performed coil embolization for those vessels for prevention of type II endoleak. Methods : Patency and diameter of aortic side branches including inferior mesenteric artery (IMA) and lumbar artery (LA) were evaluated in 56 consecutive patients with abdominal aortic aneurysm who were scheduled for EVAR...
December 25, 2017: Annals of Vascular Diseases
Sarah E Deery, Katie E Shean, Alexander B Pothof, Thomas F X O'Donnell, Barbara A Dalebout, Jeremy D Darling, Thomas C F Bodewes, Marc L Schermerhorn
OBJECTIVE: Long-term data following endovascular aortic aneurysm repair (EVAR) exist, but are limited to endografts that are no longer in use. The aim of the ENGAGE Post-Approval Study is to describe the long-term safety and effectiveness data following EVAR using the Endurant stent graft system. METHODS: From August 2011 to June 2012, 178 patients were enrolled and treated with the Endurant stent graft system. Clinical and radiologic data were prospectively collected and analyzed...
March 2, 2018: Annals of Vascular Surgery
Daniel Silverberg, Uri Rimon, Daniel Raskin, Avner BarDayan, Moshe Halak
Background "Chimney" techniques with parallel grafts used in order to extend the landing zones in endovascular aneurysm repair (ch-EVAR) are increasingly being reported. Conflicting data has been reported regarding the success and durability of the repair. We report a single center experience and outcome using ch-EVAR in treating complex aortic pathologies. Methods We performed a retrospective review of all patients treated with ch-EVAR in our institution between 2013 and 2017. Data collected included patients demographics, indications for surgery, configuration of parallel grafts, technical success, and perioperative morbidity and mortality...
January 1, 2018: Vascular
Janet T Powell, Michael J Sweeting, Pinar Ulug, Matthew M Thompson, Robert J Hinchliffe
OBJECTIVE/BACKGROUND: The aim was to describe the re-interventions after endovascular and open repair of rupture, and investigate whether these were associated with aortic morphology. METHODS: In total, 502 patients from the IMPROVE randomised trial (ISRCTN48334791) with repair of rupture were followed-up for re-interventions for at least 3 years. Pre-operative aortic morphology was assessed in a core laboratory. Re-interventions were described by time (0-90 days, 3 months-3 years) as arterial or laparotomy related, respectively, and ranked for severity by surgeons and patients separately...
March 1, 2018: European Journal of Vascular and Endovascular Surgery
Ombretta Martinelli, Mauro Fresilli, Luigi Irace, Salvatore Venosi, Jihad Jabbour, Veronica Picone, Debora Maruca, Alessia Di Girolamo, Bruno Gossetti
PURPOSE: To report the use of a Nellix endovascular aneurysm sealing (EVAS) device, to successfully treat a type Ia endoleak after an endovascular aortic repair (EVAR). CASE REPORT: A 70-years old man was diagnosed with a 90-mm aortic aneurysm, suspicious for being inflammatory. It was initially treated successfully, with a Medtronic Endurant (Medtronic, Minneapolis, MN). Five years after the index endovascular repair, an asymptomatic type Ia endoleak was detected on duplex ultrasound and computed tomographic angiogram...
March 1, 2018: Annals of Vascular Surgery
Christos D Karkos, Maria Mitka, Ioannis Pliatsios, Efthalia Xanthopoulou, Ioakeim T Giagtzidis, Christina T Papadimitriou, Konstantinos O Papazoglou
Rupture of an abdominal aortic aneurysm (AAA) after previous endovascular repair (EVAR) may require endograft explantation and replacement with a prosthetic surgical graft. Recent reports have suggested that total endograft removal during late surgical conversion in the non-ruptured setting may not be necessary and that preserving functional parts of the endograft may improve results. Similar techniques may be used for ruptured cases diminishing the magnitude of an already difficult and complex procedure. We describe the successful treatment of a ruptured AAA after previous EVAR with complete endograft preservation by combining transmural endograft fixation with sutures, proximal aortic neck banding and sac plication...
March 1, 2018: Annals of Vascular Surgery
Yoshimasa Seike, Hitoshi Matsuda, Tetsuya Fukuda, Yosuke Inoue, Atsushi Omura, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi
BACKGROUND: This study aimed to review our clinical results and determine how preoperative patent lumbar arteries (LAs) influence the occurrence of type II endoleaks or aneurysm sac enlargement after endovascular aneurysm repair (EVAR), and to identify the preoperative computed tomography findings of persistent type II endoleaks from patent LAs that indicate the need for preventive procedures during EVAR. METHODS: A total of 293 patients who underwent EVAR for infrarenal abdominal aortic aneurysm between August 2007 and July 2013 were reviewed...
February 28, 2018: Annals of Vascular Surgery
Rafaelle Spear, Jonathan Sobocinski, Adrien Hertault, Matthieu Delloye, Richard Azzauiu, Dominique Fabre, Stéphan Haulon
OBJECTIVES: To evaluate the outcomes of the second generation BeGraft balloon expandable covered stent Graft System (Bentley InnoMed, Hechingen, Germany) implanted as bridging stent grafts during fenestrated endovascular aortic repair (FEVAR) of complex aneurysms. DESIGN: This was a single centre prospective study including all consecutive patients treated by FEVAR performed with second generation BeGraft stent grafts as bridging stents. METHODS: Demographics of patients, diameter and length of the bridging stent grafts, technical success, re-interventions, occlusions, post-operative events, and imaging (Cone Beam CT and/or CT scan, and contrast enhanced ultrasound) were prospectively collected in an electronic database...
February 28, 2018: European Journal of Vascular and Endovascular Surgery
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