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Dainis K Krievins, Janis Savlovskis, Andrew H Holden, Kaspars Kisis, Andrew A Hill, Marcis Gedins, Natalija Ezite, Christopher K Zarins
OBJECTIVE: The purpose of this study was to determine the long-term effectiveness of endovascular aneurysm sealing (EVAS) in the treatment of complex aortoiliac aneurysms with preservation of hypogastric artery flow. METHODS: We reviewed all patients with abdominal aortic aneurysms (AAAs) and common iliac aneurysms (CIAs) enrolled and treated in prospective studies of EVAS using the Nellix endograft (Endologix, Irvine, Calif) at two centers from 2008 to 2014. Patients with 1 year or more of computed tomography follow-up underwent quantitative morphometric assessment by two independent vascular radiologists blinded to clinical outcome results...
November 2016: Journal of Vascular Surgery
Ombretta Martinelli, Alban Malaj, Roberto Gattuso, Luigi Irace, Bruno Gossetti
The aim of this study is to present the treatment of a juxtarenal inflammatory aneurysm using a Nellix device (Endologix, Inc., Irvine, CA) to seal the entire aneurysmatic aorta combined with bilateral iliac-renal bypass using the Gore hybrid vascular graft (W. L. Gore & Associates, Inc., Flagstaff, AZ). A 63-year-old man was diagnosed with a 6-cm juxtarenal inflammatory aneurysm. It was initially decided to treat him with an aorto-aortic bypass and to revascularize the 2 renal arteries with "graft to renal artery bypass" using Gore hybrid vascular grafts...
September 22, 2016: Annals of Vascular Surgery
George A Antoniou, Khalid Bashaeb, Riza Ibrahim
No abstract text is available yet for this article.
September 6, 2016: VASA. Zeitschrift Für Gefässkrankheiten
Steven Mm van Sterkenburg, Leo H van den Ham, Luuk Smeets, Jan-Willem Lardenoije, Michel Mpj Reijnen
INTRODUCTION: Concomitant abdominal aortic aneurysm formation and aortoiliac occlusive disease is a challenging combination, often requiring open reconstructive surgery. In this study, we have assessed a single center experience of the Nellix EndoVascular Aneurysm Sealing System in the treatment of an abdominal aortic aneurysm in conjunction with iliac artery occlusive disease. METHODS: Retrospectively case files of patients treated with Nellix EndoVascular Aneurysm Sealing System in a single center were reviewed...
August 31, 2016: Vascular
Matt M Thompson, Jan M Heyligers, Paul D Hayes, Michel M P J Reijnen, Dittmar Böckler, Hubert Schelzig, Jean-Paul P M de Vries, Dainis Krievins, Andrew Holden
PURPOSE: To report the early and 12-month results of a global registry of patients treated with endovascular aneurysm sealing (EVAS) for abdominal aortic aneurysms (AAAs). METHODS: The EVAS FORWARD Global Registry was a postmarket, multicenter, open-label, single-arm registry that enrolled 277 patients (mean age 75 years; 228 men) treated with the Nellix EVAS system for nonruptured AAAs at 18 sites over a 1-year period. The cohort had challenging aortic anatomy, with 17% having a proximal aortic neck length <10 mm, 8% a neck angulation >60°, and 20% an iliac diameter >25 mm...
October 2016: Journal of Endovascular Therapy
J L De Bruin, J R Brownrigg, B O Patterson, A Karthikesalingam, P J Holt, R J Hinchliffe, I M Loftus, M M Thompson
BACKGROUND: The chimney technique using parallel grafts offers an alternative to fenestrated or branched endovascular solutions for juxtarenal and suprarenal aneurysms. Endograft deployment proximal to the renal or visceral ostia is combined with parallel stents to the aortic side branches. Application of the chimney technique using the Nellix device (Ch-EVAS) may offer some potential advantages with respect to the seal between the endograft and the parallel grafts. This study aimed to investigate the feasibility and efficacy of the Nellix endovascular aneurysm sealing (EVAS) system in conjunction with parallel grafts for the treatment of juxtarenal and suprarenal aneurysms...
October 2016: European Journal of Vascular and Endovascular Surgery
Lik Fai Cheng, Kwok Fai Cheung, Kwong Man Chan, Johnny Ka Fai Ma, Wing Hang Luk, Micah Chi King Chan, Carol Wing Kei Ng, Neeraj Ramesh Mahboobani, Wai Kin Ng, Ting Wong
Nellix Endovascular Aneurysm Sealing (EVAS) system is a new concept and technology of abdominal aortic aneurysm (AAA) repair. Elective EVAS using Nellix device was performed for a 83-year-old man with AAA. 2-month post-EVAS CTA surveillance demonstrated mild enlargement of aneurysmal sac and separation of the EndoBags, but without detectable endoleak. The patient developed sudden AAA rupture with retroperitoneal hematoma at about 4 months after EVAS. We postulated that early enlargement of aneurysmal sac and separation of EndoBags of Nellix devices after EVAS, even without detectable endoleak, might indicate significant aneurysmal wall weakening with increased risk of later AAA rupture...
July 5, 2016: Cardiovascular and Interventional Radiology
Roberto Silingardi, Giovanni Coppi, Emanuele Ferrero, Antonio Lauricella, Daniele Psacharopulo, Giuseppe Saitta, Andrea Viazzo, Michelangelo Ferri
PURPOSE: To report midterm outcomes of the Nellix Endovascular Aneurysm Sealing (EVAS) System in the treatment of abdominal aortic aneurysm (AAA). METHODS: Between September 2013 and July 2014, 64 AAA patients (mean age 76.6±6.8 years; 61 men) were treated with the EVAS system at 2 centers (only procedures performed at least 12 months prior to the analysis were included). Most patients were treated for a stable AAA, while 1 patient was treated for a ruptured aneurysm...
October 2016: Journal of Endovascular Therapy
Andrew England, Francesco Torella, Robert K Fisher, Richard G McWilliams
BACKGROUND: This study reports the incidence and sequelae of migration of the Nellix (Endologix Inc, Irvine, Calif) endoprosthesis after endovascular aneurysm sealing. METHODS: A review was performed of the follow-up imaging of all endovascular aneurysm sealing patients in a university hospital endovascular program who had a minimum follow-up of 1 year. The first postoperative and latest follow-up computed tomography scans were used to measure the distances between the proximal and distal borders of the stent grafts relative to reference vessels using a previously validated technique...
April 9, 2016: Journal of Vascular Surgery
Francesco Torella, James R H Scurr, Mo Barkat, Robert K Fisher, Richard G McWilliams
PURPOSE: To describe a technique to rescue intraoperative migration of 1 of the 2 Nellix stents during endovascular sealing of abdominal aortic aneurysms (EVAS). TECHNIQUE: The technique requires advancement and inflation of a 10-mm angioplasty balloon into the inlet of the migrated stent via an upper limb approach. Inflation of the balloon allows completion of EVAS without risking the contralateral endobag occluding the inlet of the migrated stent. CONCLUSION: This technique allows safe completion of EVAS without compromising stent patency or aneurysm seal and should be considered when intraoperative migration of a Nellix stent occurs despite appropriate precautions...
June 2016: Journal of Endovascular Therapy
Marwan Youssef, Friedrich Dünschede, Hazem El Beyrouti, Ora Salem, Christian-Friedrich Vahl, Bernhard Dorweiler
Background We demonstrate our initial experience and first results of the endovascular aneurysm sealing (EVAS) technology with chimney grafts for the treatment of paravisceral aneurysms. Methods We present a consecutive series of seven patients with a mean age of 75 years who had been treated by four-vessel-chimney EVAS (ChEVAS) between May 2014 and May 2015. All patients were ASA grade ≥ III and were not eligible for fenestrated/branched endovascular aortic repair (fEVAR/brEVAR) due to urgency (n = 5) or anatomical constraints (n = 2)...
February 18, 2016: Thoracic and Cardiovascular Surgeon
Charles Swaelens, Robert J Poole, Francesco Torella, Richard G McWilliams, Andrew England, Robert K Fisher
PURPOSE: To examine the changes in distraction force following relining of a conventional abdominal aortic stent-graft with a type IIIb endoleak using the Nellix endovascular sealing device compared to a unilateral stent-graft. METHODS: Relining is often used to repair type IIIb endoleaks, but the consequences to graft stability are unknown. A mathematical model was constructed based on pressure and volume flow through the stent-grafts, incorporating recognized distraction force equations...
April 2016: Journal of Endovascular Therapy
John Julian Harvey, Brew Stefan, Andrew Hill, Andrew H Holden
The successful transcatheter treatment of a type IA endoleak after endovascular aortic aneurysm sealing with the Nellix EndoVascular Aneurysm Sealing system (Endologix Inc, Irvine, California) using proximal covered stent extension and transarterial N-butyl cyanoacrylate sac embolization is described. Three patients were treated using the same technique with a mean interval between the index procedure and reintervention of 9.3 months (range, 3-15 mo). No complications or endoleaks were seen on follow-up imaging...
February 2016: Journal of Vascular and Interventional Radiology: JVIR
Marwan Youssef, Zmarai Nurzai, Sebastian Zerwes, Rudolf Jakob, Fritz Dünschede, Bernhard Dorweiler, Christian F Vahl
PURPOSE: To assess the feasibility and effectiveness of the Nellix prosthesis in the treatment of common iliac artery aneurysms. METHODS: Between May 2013 and June 2015, 230 patients underwent implantation of the Nellix device at 2 institutions. Fifty of these patients (mean age 76 years; 35 men) were identified as having 60 common iliac artery aneurysms (CIAAs) with a median diameter of 4 cm (range 3.5-7). The majority of patients had aortoiliac aneurysms (5, 70%), 10 (20%) had isolated CIAAs, and 5 (10%) had iliac anastomotic aneurysms after aortoiliac bypass...
April 2016: Journal of Endovascular Therapy
Michel M P J Reijnen, Jorg L de Bruin, Elke G E Mathijssen, Eric Zimmermann, Andrew Holden, Paul Hayes, Dainis Krievins, Dittmar Böckler, Jean-Paul P M de Vries, Matt M Thompson
PURPOSE: To assess the feasibility and safety of the endovascular aneurysm sealing (EVAS) technique in the treatment of acute abdominal aortic aneurysm (AAA). METHODS: A retrospective, multicenter, observational study was conducted at 8 centers (7 European and 1 in New Zealand) experienced with EVAS in the elective setting. From February 2013 to April 2015, 58 patients (mean age 74±9 years; 46 men) with an acute AAA were treated (28 ruptured and 30 symptomatic)...
February 2016: Journal of Endovascular Therapy
Andrew Holden, Janis Savlovskis, Andrew Winterbottom, Leo H van den Ham, Andrew Hill, Dainis Krievins, Paul D Hayes, Michel M P J Reijnen, Dittmar Böckler, Jean-Paul P M de Vries, Jeffrey P Carpenter, Matt M Thompson
Endovascular aneurysm sealing (EVAS) using the Nellix system is a new and different method of abdominal aortic aneurysm repair. Normal postoperative imaging has unique appearances that change with time; complications also have different and specific appearances. This consensus document on the imaging findings after Nellix EVAS is based on the collective experience of the sites involved in the Nellix EVAS Global Forward Registry and the US Investigational Device Exemption Trial. The normal findings on computed tomography (CT), duplex ultrasound, magnetic resonance imaging, and plain radiography are described...
February 2016: Journal of Endovascular Therapy
Sebastian Zerwes, Zmarai Nurzai, Giesbert Leissner, Thomas Kroencke, Hans-Kees Bruijnen, Rudolf Jakob, Klaus Woelfle
OBJECTIVE: In the present study, 50 EVAS procedures were evaluated in regard to primary (survival and technical success) and secondary (device-related complications) events of interest. METHODS: The single center study was conducted from July 2013 to August 2014 with prospective collection of the clinical data. The clinical results were controlled by CT angiography and contrast-enhanced ultrasound. RESULTS: The technical success was 98% and the 30-day mortality 4%...
August 2016: Vascular
Thijs G ter Mors, Steven M M van Sterkenburg, Leo H van den Ham, Michel M P J Reijnen
PURPOSE: To report the application of the Nellix endovascular aneurysm sealing system to successfully treat a unilateral common iliac aneurysm and preserve the internal iliac artery. CASE REPORT: An 85-year-old man presented with right-sided necrosis of the third and fourth toe. Computed tomography angiography (CTA) showed a right 40-mm popliteal aneurysm and a 38-mm left fusiform common iliac artery aneurysm. After endovascular exclusion of the popliteal aneurysm, the Nellix device was positioned to exclude the common iliac artery aneurysm while preserving the internal iliac artery...
December 2015: Journal of Endovascular Therapy
J T Boersen, R C L Schuurmann, C H Slump, D A F van den Heuvel, M M P J Reijnen, T G ter Mors, A C Vahl, J P P M de Vries
OBJECTIVE: Endovascular aortic sealing (EVAS) with the Nellix endosystem (Endologix, Irvine, CA, USA) is a new concept to treat infrarenal abdominal aortic aneurysms (AAAs). By sealing the aneurysm, potential endoleaks may be avoided. Early results of EVAS are good, but no data have been published regarding peri-procedural changes in aortoiliac anatomy. In this study, 27 consecutive patients who underwent elective EVAS repair of an AAA were reviewed. METHOD: Specific AAA (diameter, length from renal arteries to aortic bifurcation, supra- and infrarenal neck angulation, AAA volume, thrombus volume, and flow lumen volume), and iliac artery characteristics (length, angulation, location of most severe angulation with reference to the origin of the common iliac artery) were determined from pre- and post-procedural reconstructed computed tomography angiograms...
January 2016: European Journal of Vascular and Endovascular Surgery
B Gossetti, A Malaj, A Alunno, O Martinelli
BACKGROUND: Endovascular aneurysm sealing (EVAS) using the Nellix system is a promising technology for Abdominal Aortic Aneurysm (AAA) treatment. Long-term data is unavailable regarding the potential modifications of the EndoBags and their content, and the polymer behavior over time. We present our initial clinical experience with this sac anchoring endoprosthesis in 24 patients with a maximum 12 months follow-up. METHODS AND RESULTS: From December 2013 to March 2015, 24 patients with an infrarenal AAA were treated with the NellixTM System...
September 29, 2015: Journal of Cardiovascular Surgery
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