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https://www.readbyqxmd.com/read/29785859/apposition-and-positioning-of-the-nellix-endovascular-aneurysm-sealing-system-in-the-infrarenal-aortic-neck
#1
Kim van Noort, Simon P Overeem, Ruben van Veen, Jan M M Heyligers, Michel M P J Reijnen, Richte C L Schuurmann, Cornelis H Slump, Rogier Kropman, Jean-Paul P M de Vries
PURPOSE: To investigate the initial proximal position and seal of the Nellix EndoVascular Aneurysm Sealing (EVAS) system in the aortic neck using a novel methodology. METHODS: Forty-six consecutive patients who underwent elective EVAS for an abdominal aortic aneurysm were retrospectively selected and dichotomized into an early (n = 23) and a late (n = 23) group. The aortic neck morphology and aortic neck surface (ANS) were determined on preoperative computed tomography (CT) scans; the endograft position and nonapposition surface (NAS) were determined on the 1-month CT scans...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29778615/explanting-the-nellix-endovascular-aortic-sealing-endoprosthesis-for-proximal-aortic-neck-failure
#2
Cheong Jun Lee, Robert Cuff
Open conversion following endovascular aortic repair (EVAR) has inherent challenges particular to the device being explanted. The Nellix endograft is unlike any other device as it utilizes polymer filling of endobags within the aorto-iliac lumen to seal the AAA sac; a developing concept known as endovascular aortic sealing (EVAS). Conversion to open repair of AAA treated with the Nellix endograft have rarely been discussed. Explants that have been previously reported were for graft infection. We present two Nellix graft explants that were required for device migration and subsequent development of a type IA endoleak...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29775657/stabilization-of-the-abdominal-aorta-during-the-cardiac-cycle-with-the-sac-anchoring-nellix-device
#3
Nathan K Itoga, Ga-Young Suh, Christopher P Cheng
The Nellix device utilizes polymer filled endobags to stabilize the abdominal aortic aneurysm (AAA) sac described as endovascular aneurysm sealing (EVAS). We analyzed cardiac gated CTA scans of repaired AAA with EVAS in four patients to evaluate geometry and cardiac pulsatility-induced deformation. Graft translation and aortic curvature changes were found to be minimal during the cardiac cycle. The mean±SD changes in renal-aorta angles (1.0±0.9°) were less than the changes in the SMA-aorta angle (4.0±2...
May 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29725808/endovascular-aneurysm-sealing-evas-alone-or-in-combination-with-chimney-grafts-chevas-for-treating-complications-of-previous-endovascular-aneurysm-repair-evar-procedures
#4
Kosmas I Paraskevas, Maria Karouki, Adeeb Rehman, Francesco Torella, Richard G McWilliams, Andrew England, Robert K Fisher
OBJECTIVE: Late complications after previous endovascular aneurysm repair (EVAR) procedures include type I/III endoleaks causing aneurysm growth and rupture. We reviewed our results from the management of such complications with endovascular aneurysm sealing (EVAS) techniques. METHODS: Analysis of our prospectively maintained aneurysm database was performed (December 2013-May 2017). Primary outcomes were: (1) success of the procedure in excluding the primary complication, (2) perioperative mortality, (3) post-operative complications and (4) survival...
May 3, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29685659/a-technique-of-chimney-nellix-for-the-management-of-type-1a-endoleak-after-evar
#5
Simon Z Joseph, C H Ricky Kwok, Joseph A Hockley, Marek W Garbowski, John Ferguson, Shaun Samuelson, Shirley J Jansen
This report presents 3 procedures with visceral "chimney stenting" in conjunction with an endovascular aneurysm sealing (EVAS) device, known as chEVAS, for treatment of type 1a endoleak. It includes the first published chEVAS in a patient with previous fenestrated endovascular aneurysm repair (FEVAR). Cases include an 80-year-old man 8 years after FEVAR for a juxtarenal abdominal aortic aneurysm (AAA); an 85-year-old woman 9 months after endovascular aneurysm repair (EVAR) for a ruptured infrarenal AAA; and an 84-year-old woman 3 months after EVAR for a symptomatic infrarenal AAA...
May 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29616520/comparison-of-endovascular-aneurysm-sealing-and-repair-with-respect-to-contrast-use-and-radiation-in-comparable-patient-cohorts
#6
Andreas S Peters, Johannes Hatzl, Moritz S Bischoff, Dittmar Böckler
BACKGROUND: Due to recent advances in endograft design and percutaneous access, technical success could be increased during endovascular aneurysm repair (EVAR). Beside EVAR, endovascular aneurysm sealing (EVAS) provides an alternative procedure to treat aneurysms. To compare the two methods, additional benchmark criteria should be evaluated: Screening time, dose area product (DAP), procedure time and contrast use. In this study these technical variables are analysed for EVAS vs. EVAR in comparable patient cohorts...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29609994/refinement-of-anatomic-indications-for-the-nellix-system-for-endovascular-aneurysm-sealing-based-on-2-year-outcomes-from-the-evas-forward-ide-trial
#7
Jeffrey P Carpenter, John S Lane, Jose Trani, Sajjad Hussain, Christopher Healey, Clifford J Buckley, Homayoun Hashemi, Robert Cuff
BACKGROUND: The Nellix System (Endologix, Inc, Irvine, Calif) for endovascular aneurysm sealing (EVAS) is a novel approach to abdominal aortic aneurysm treatment and conceptually different from endovascular aneurysm repair, whereby polymer is employed to fill and actively manage the abdominal aortic aneurysm sac. One-year safety and effectiveness results of the Nellix pivotal trial demonstrated encouraging outcomes with very low morbidity and mortality and high procedural and treatment success...
March 30, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29591724/two-year-outcomes-of-the-nellix-endovascular-aneurysm-sealing-system-for-treatment-of-abdominal-aortic-aneurysms
#8
Aleksandra C Zoethout, Johannes T Boersen, Jan M M Heyligers, Jean-Paul P M de Vries, Clark J A M Zeebregts, Michel M P J Reijnen
PURPOSE: To analyze the 2-year outcomes of endovascular aneurysm sealing (EVAS) according to 2 versions of the instructions for use (IFU). METHODS: A retrospective study was conducted involving 355 consecutive patients treated with the first-generation EVAS device from April 2013 to December 31, 2015, at 3 high-volume centers. Out of 355 patients treated with EVAS, 264 were elective asymptomatic infrarenal EVAS procedures suitable for analysis. In this cohort, 168 (63...
March 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29575981/endobag-separation-an-ominous-sign-after-endovascular-aneurysm-sealing-with-the-nellix-device
#9
Sadia Tasleem, Hassan Badri, Narlawar Ranjeet, George A Antoniou
Our report aims to alert physicians performing endovascular aneurysm sealing with the Nellix endoprosthesis to the risk of rupture when endobag separation is noticed on computed tomography. Endobag separation when observed with acute presentation of abdominal pain is an indicator of imminent rupture and prompt interventional treatment should be undertaken.
March 26, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29501907/an-alternative-approach-for-treating-a-type-ia-endoleak-after-conventional-evar-using-the-nellix-endovascular-aneurysm-sealing
#10
Ombretta Martinelli, Mauro Fresilli, Luigi Irace, Salvatore Venosi, Jihad Jabbour, Veronica Picone, Debora Maruca, Alessia Di Girolamo, Bruno Gossetti
BACKGROUND: To report the use of a Nellix endovascular aneurysm sealing (EVAS) device, to successfully treat a type Ia endoleak (EL) after an endovascular aortic repair (EVAR). CASE REPORT: A 70-year-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, USA). Five years after the index endovascular repair, an asymptomatic type Ia EL was detected on duplex ultrasound and computed tomographic angiogram...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29428533/greater-compliance-within-instruction-for-use-for-concomitant-iliac-aneurysms-and-adverse-aneurysm-characteristics-initial-experience-with-the-nellix-endovascular-aneurysm-sealing-system-at-a-single-institution
#11
Jun X Jeffrey Hing, Jack K Ch'ng, Kiang H Tay, Tze T Chong
BACKGROUND: The Nellix was introduced to Asia in 2014. Data in Asians have been sparse. Two balloon-expandable stents, each surrounded by a polymer-filled endobag, are deployed in parallel to obliterate and seal the aneurysm. This paradigm shift to treating abdominal aortic aneurysms confers advantages for certain adverse aneurysm morphology that is outside the instruction-for-use (IFU) for standard endovascular aneurysm repair (EVAR) devices. We examine outcomes of 15 Asian patients with concomitant infrarenal aortic and iliac artery aneurysms treated with the Nellix at our institution...
February 9, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29380655/status-of-endovascular-aneurysm-sealing-after-5-years-of-commercial-use
#12
Michel M P J Reijnen, Andrew Holden
Endovascular aneurysm sealing (EVAS) using the Nellix Endovascular Sealing System was introduced commercially in 2013 with the aim of reducing the incidences of reintervention and late complications observed after conventional endovascular aneurysm repair (EVAR). In the 5 years since its commercial launch, the Nellix system has evolved in terms of its structure, instructions for use, and delivery technique. Complications, including migration and proximal endoleak, have been recognized and treatment strategies developed, although durability remains to be demonstrated...
April 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29325136/haemodynamic-performance-of-afx-and-nellix-endografts-a-computational-fluid-dynamics-study
#13
Anastasios Raptis, Michalis Xenos, George Kouvelos, Athanasios Giannoukas, Miltiadis Matsagkas
OBJECTIVES: The objective of this study is to analyse the flow conditions in the AFX and Nellix endografts (EGs) accounting for their postimplantation configuration in patients with an endovascular aneurysm repair-treated abdominal aortic aneurysm. METHODS: We reconstructed post-endovascular aneurysm repair computed tomography scans of patients treated with an AFX or Nellix EG creating post-implantation EG models. We examined 16 patients, 8 in each group. The blood flow properties were obtained by computational fluid dynamics simulations and were subsequently compared with physiological infrarenal blood flow properties measured in 5 healthy subjects...
January 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29251206/temporal-changes-in-intraluminal-thrombus-volume-within-abdominal-aortic-aneurysms-implications-for-planning-endovascular-aneurysm-sealing
#14
Kosmas I Paraskevas, Francesco Torella, Charles Swaelens, Andrew England, Tze Y Chan, Usman Shaikh, Richard G McWilliams, Robert K Fisher
PURPOSE: To explore whether or not there are temporal changes in the abdominal aortic aneurysm (AAA) and intraluminal thrombus (ILT) volumes between planning and implantation of the endovascular aneurysm sealing (EVAS) device and how these changes influence lumen volume. METHODS: A retrospective review was conducted of 51 AAA patients (mean age 76±7.1 years; 36 men) in whom 2 serial preoperative computed tomography angiograms (CTAs) had been performed within 1 to 18 months before fenestrated endovascular repair...
February 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29246081/uncovered-chimney-stent-graft-for-renal-arteries-with-the-nellix-endovascular-aneurysm-sealing-technique
#15
Luca Garriboli, Antonio Maria Jannello
PURPOSE: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs). CASE REPORT: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration...
February 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29242065/preliminary-results-of-endovascular-aneurysm-sealing-from-the-multicenter-italian-research-on-nellix-endoprosthesis-irene-study
#16
Bruno Gossetti, Ombretta Martinelli, Michelangelo Ferri, Roberto Silingardi, Fabio Verzini
OBJECTIVE: Because of advances in technology and experience of the operator, endovascular aneurysm repair (EVAR) has supplanted open repair to treat abdominal aortic aneurysm (AAA). The low 30-day mortality and morbidity of EVAR make the endovascular approach particularly suitable for patients at high surgical risk. However, endoleak or endograft migration requiring secondary intervention or open surgical conversion is a limitation of EVAR. The Nellix system (Endologix, Inc, Irvine, Calif) has been designed to seal the entire AAA to overcome these limitations with EVAR...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29234734/endovascular-aneurysm-sealing-for-management-of-aortic-occlusive-disease
#17
Ahmed Elbasty, Michael Crawford, Darren Morrow
Introduction: Endovascular management of aortic occlusive disease is an alternative to open surgery. This case describes the use of a Nellix graft to treat infrarenal aortic stenosis, outwith the graft indication for use. Case report: A 71 year old man with multiple comorbidities, presented with bilateral buttock claudication. A computed tomography angiogram (CTA) showed significant infrarenal aortic stenosis. Under local anaesthetic, using a percutaneous approach, Nellix grafts were inserted...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29219029/determination-of-stent-frame-displacement-after-endovascular-aneurysm-sealing
#18
Ruben van Veen, Kim van Noort, Richte C L Schuurmann, Jan Wille, Cornelis H Slump, Jean-Paul P M de Vries
PURPOSE: To describe and validate a new methodology for visualizing and quantifying 3-dimensional (3D) displacement of the stent frames of the Nellix endosystem after endovascular aneurysm sealing (EVAS). METHODS: The 3D positions of the stent frames were registered to 5 fixed anatomical landmarks on the post-EVAS computed tomography (CT) scans, facilitating comparison of the position and shape of the stent frames between consecutive follow-up scans. Displacement of the proximal and distal ends of the stent frames, the entire stent frame trajectories, as well as changes in distance between the stent frames were determined for 6 patients with >5-mm displacement and 6 patients with <5-mm displacement at 1-year follow-up...
February 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29089283/editor-s-choice-occurrence-and-classification-of-proximal-type-i-endoleaks-after-endovascular-aneurysm-sealing-using-the-nellix%C3%A2-device
#19
Leo H van den Ham, Andrew Holden, Janis Savlovskis, Andrew Witterbottom, Kenneth Ouriel, Michel M P J Reijnen
OBJECTIVE/BACKGROUND: Proximal type I endoleaks are associated with abdominal aortic aneurysm (AAA) growth and rupture and necessitate repair. The Nellix™ EndoVascular Aneurysm Sealing (EVAS) system is a unique approach to AAA repair, where the appearance and treatment of endoleaks is also different. This study aimed to analyse and categorise proximal endoleaks in an EVAS treated cohort. METHODS: All patients, treated from February 2013 to December 2015, in 15 experienced EVAS centres, presenting with proximal endoleak were included...
December 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29032904/endovascular-aortic-sealing-with-nellix-reduces-intraoperative-radiation-dose-when-compared-to-endovascular-aortic-repair
#20
Stefan Ockert, Mirjam Heinrich, Thomas Kaufmann, Thomas Syburra, Ruben Lopez, Robert Seelos
OBJECTIVE: To analyze radiation exposure during endovascular aortic sealing (EVAS) in comparison with standard endovascular aortic repair (EVAR) in clinical practice. METHODS: From December 2013 to October 2016 (35 months), 60 patients were analyzed for intraoperative radiation exposure during EVAR: 30 consecutive patients (mean age, 73.10 years; 28 male) received EVAS (Nellix Endologix); within the same time frame, 30 patients were treated with standard EVAR (mean age, 71...
October 9, 2017: Journal of Vascular Surgery
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