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Endovascular aneurysm repair

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https://www.readbyqxmd.com/read/27928584/endovascular-management-of-infected-femoral-artery-pseudoaneurysms-in-high-risk-patients-a-case-series
#1
Mario D'Oria, Giada Sgorlon, Cristiano Calvagna, Francesca Zamolo, Stefano Chiarandini, Roberto Adovasio, Filippo Griselli
We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period. Endovascular therapy represents a feasible treatment option for IFAPs in those patients for whom the risk of open surgical repair would be prohibitive, especially under urgent circumstances...
December 7, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27928064/3d-printing-guiding-stent-graft-fenestration-a-novel-technique-for-fenestration-in-endovascular-aneurysm-repair
#2
Jianhua Huang, Gan Li, Wei Wang, Keming Wu, Tianming Le
OBJECTIVE: To describe a novel approach, 3D printing guiding stent graft fenestration, for fenestration during endovascular aneurysm repair for juxtarenal abdominal aortic aneurysm. METHODS: A 69-year-old male with juxtarenal abdominal aortic aneurysm underwent endovascular aneurysm repair with "off the label" fenestrated stent graft. To precisely locate the fenestration position, we reconstructed a 3D digital abdominal aortic aneurysm model and created a skin template covering this abdominal aortic aneurysm model...
December 6, 2016: Vascular
https://www.readbyqxmd.com/read/27924434/prophylactic-antibiotics-for-percutaneous-endovascular-procedures
#3
REVIEW
N S Greaves, E Katsogridakis, B Faris, D Murray
Percutaneous endovascular techniques are used increasingly in the vascular armamentarium. Commonly performed as day case procedures under local anaesthetic, they are suited to the highly co-morbid vascular patient population. Furthermore, technological advances have resulted in ever improving outcomes for aneurysmal and occlusive disease. Endovascular procedures such as endovascular aneurysm repair or iliac artery stenting are traditionally associated with reduced infectious complications compared to equivalent open techniques...
December 6, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27921203/treatment-of-uncomplicated-type-b-aortic-dissection
#4
REVIEW
Hitoshi Matsuda
Hospital mortality after the replacement of chronic type B aortic dissection is around 8-10% and adverse outcomes include paraplegia and stroke. However, the level of evidence for indication of thoracic endovascular aortic repair (TEVAR) for type B chronic aortic dissection is Class IIa. Results of the INSTEAD-XL trial have verified that preemptive TEVAR for uncomplicated type B aortic dissection improves prognosis. The indication for this procedure is reportedly a maximum aortic diameter >40 mm during the acute phase and a patent primary entry site in the thoracic aorta, while the optimal timing for TEVAR would be the subacute phase, from 2 weeks to 3-6 months after onset...
December 5, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27919458/impact-of-preoperative-pulmonary-function-on-outcomes-after-open-repair-of-descending-and-thoracoabdominal-aortic-aneurysms
#5
Leonard N Girardi, Christopher Lau, Monica Munjal, Mohamed Elsayed, Ivancarmine Gambardella, Lucas B Ohmes, Mario Gaudino
OBJECTIVE: To evaluate the impact of preoperative pulmonary function on outcomes after open repair of descending thoracic (DTA) and thoracoabdominal aortic (TAAA) aneurysms. METHODS: The outcomes of patients undergoing open repair of DTA or TAAA were analyzed in relation to the results of preoperative pulmonary function tests. Receiver operating characteristic was adopted to assess the effect of forced expiratory volume in one second (FEV1) on the incidence of mortality...
November 10, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27918318/alternative-treatment-for-residual-aortobronchial-fistula-after-thoracic-endovascular-aortic-repair
#6
Kosuke Ujihira, Yoshihiko Kurimoto, Ryushi Maruyama, Yutaka Iba, Naritomo Nishioka, Akira Yamada, Katsuhiko Nakanishi, Hiroaki Kato, Masaru Abe, Yoshiaki Narita, Masayuki Osawa
A patient with an aortobronchial fistula secondary to a thoracic endovascular aortic repair was successfully treated with a re-thoracic endovascular aortic repair with debranching technique. Five months postoperatively, the aneurysm had shrunk; however, computed tomography revealed air in the thrombo-excluded aortic aneurysmal sac without signs of infection. Because of worsening air finding at the eighth month, we performed a resection of the residual fistula and wrapped the stent graft in a pedicled muscle flap...
December 1, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27914637/redo-thoracoabdominal-aortic-aneurysm-repair-a-single-center-experience-over-25%C3%A2-years
#7
Rana O Afifi, Harleen K Sandhu, Amy E Trott, Tom C Nguyen, Charles C Miller, Anthony L Estrera, Hazim J Safi
BACKGROUND: Aortic disease is a lifelong, progressive illness that may require repeated intervention over time. We reviewed our 25-year experience with open redo thoracoabdominal aortic aneurysm (TAAA) and descending thoracic aortic aneurysm (DTAA) repair. Our objectives were to determine patient outcomes after redo repair of DTAA/TAAA and compare them with nonredo repair. We also attempted to identify the risk factors for poor outcome. METHODS: We reviewed all open redo TAAA and DTAA repairs between 1991 and 2014...
November 30, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27909281/-transaortic-thoracic-endovascular-aortic-repair-via-right-anterior-mini-thoracotomy-report-of-a-case
#8
Keitaro Okamoto, Tomoyuki Wada, Hirofumi Anai, Satoshi Takebayashi, Takashi Shuto, Takayuki Kawashima, Kazuki Mori, Norio Hongo, Noritaka Kamei, Hiromu Mori, Shinji Miyamoto
An 81-year-old man presented with ruptured thoracic aortic aneurysm under stable condition. He had been suffering from chronic obstructive pulmonary disease, chronic renal failure and rheumatoid arthritis. We performed hybrid thoracic endovascular aortic repair via right anterior mini-thoracotomy inserting a device through a conduit on the ascending aorta. The patient was discharged without aorta-related complications.
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27908817/clinical-outcome-after-endovascular-sealing-of-abdominal-aortic-aneurysms-evas-a-retrospective-cohort-study
#9
Maria Karouki, Charles Swaelens, Luigi Iazzolino, Richard G McWilliams, Robert K Fisher, Andrew England, Francesco Torella
PURPOSE: To present the clinical outcome of endovascular sealing of abdominal aortic aneurysms (EVAS) with the Nellix endoprosthesis in patients with abdominal aortic aneurysms treated in our institution. METHODS: This was a retrospective, single centre, observational cohort study. A departmental database was interrogated in order to extract demographics, clinical information and outcome of all patients treated with EVAS between December 2013 and December 2015. Outcome measures included technical success (successful device deployment and absence of any endoleak at completion angiography), mortality, major complications, incidence of endoleaks, aneurysm rupture and reintervention...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#10
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908813/coil-embolization-assisted-thoracic-endovascular-aortic-repair-for-multiple-saccular-descending-aortic-aneurysms-with-insufficient-landing-zone
#11
Akito Imai, Tomomi Nakajima, Masataka Sato, Yasunori Watanabe, Shunichi Kondo, Motoo Osaka, Yuji Hiramatsu
We report a coil embolization -assisted thoracic endovascular aortic repair technique successfully applied to multiple saccular descending aortic aneurysms in a 74-year-old man. Due to the most distal aneurysm being located at the celiac trunk level and the distance between the superior mesenteric artery and the aneurysm being only 10mm, a coil embolization of the distal saccular aneurysm was performed prior to stent delivery to secure a sufficient landing zone. Postoperative computed tomography showed an appropriate positioning of the endovascular devices without endoleak...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908811/decreased-serum-levels-of-high-mobility-group-box-1-hmgb-1-after-graft-replacement-or-stenting-of-abdominal-aortic-aneurysm
#12
Daiki Ousaka, Yasuhiro Fujii, Susumu Oozawa, Masahiro Nishibori, Yosuke Kuroko, Zenichi Masuda, Shunji Sano
OBJECTIVES: High-mobility group box 1 (HMGB-1) is a key substance mediating inflammation and development of atherosclerotic lesions (AL), including abdominal aortic aneurysms (AAA). Serum levels of HMGB-1 are increased in patients with AAA than in normal controls because the ALs in AAAs secrete HMGB-1. We therefore postulate that the serum HMGB-1 level should decrease after endovascular aortic repair (EVAR) or open aortic repair (OAR). However, there is no evidence of this in the literature...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908809/a-combination-of-thoracic-and-abdominal-grafts-to-treat-an-abdominal-aortic-aneurysm-with-hostile-proximal-neck
#13
Mafalda Massara, Roberto Prunella, Pasquale Gerardi, Giovanni De Caridi, Raffaele Serra, Stefano Notarstefano, Giovanni Impedovo
Endovascular aneurysm repair (EVAR) actually represents the treatment of choice for most patients affected by aneurysm of the abdominal aorta (AAA). However, the feasibility of EVAR depends on anatomical characteristics of abdominal aorta and ilio-femoral axis. We present the case of a 82-years old man affected by severe left hydronephrosis, kidney and ureteral tumor requiring nephrectomy, that presented also a very voluminous AAA with a large diameter (96 mm), presenting also with a large proximal neck (39 mm) and with a severe angulation of the proximal neck (> 60°)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908807/incomplete-expansion-of-chimney-stent-graft-during-chimney-thoracic-endovascular-aneurysm-repair-ch-tevar
#14
Athanasios Katsargyris, Domenico Spinelli, Kyriakos Oikonomou, Hozan Mufty, Eric Lg Verhoeven
PURPOSE: To report a technical complication during a chimney-thoracic endovascular aneurysm repair (Ch-TEVAR) procedure. CASE REPORT: A 77 year-old female patient underwent Ch-TEVAR for a symptomatic thoracic aortic aneurysm (TAA) with a short and angulated proximal neck. Deployment of the aortic stent-graft over the left subclavian artery (LSA) was followed by placement of a balloon expandable covered stent as a chimney for the LSA. Chimney deployment failed due to balloon perforation...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27905691/is-volume-important-in-aneurysm-treatment-outcome
#15
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27905690/learning-curve-in-fenestrated-and-branched-grafting
#16
Teresa Martin-Gonzalez, Tara M Mastracci
In surgical practice new technologies and techniques require a period of adjustment before the main operator becomes familiar with the new procedure, improving the results and the performances. This period, called learning curve, could be applied into the endovascular aortic treatment. The CUSUM technique had been used to define the learning curve in new procedures and through the literature some studies applied it to demonstrate the improving outcomes in complex endovascular aneurysm repair during increasing experience time...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27904110/infected-aortic-aneurysm-mimicking-anti-proteinase-3-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#17
Kenta Hachiya, Kazuaki Wakami, Atsuhiro Yoshida, Hisao Suda, Nobuyuki Ohte
We herein report an unusual case of an infected descending aortic pseudoaneurysm with luminal pathognomonic oscillating vegetation with serological findings and clinical features mimicking anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis. The positive blood cultures and imaging findings, including a pseudoaneurysm and vegetations in the aorta, suggested the presence of an infected aortic aneurysm. The patient was successfully treated with antibiotics and endovascular aortic repair...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27903931/comparison-of-perioperative-outcomes-in-endovascular-versus-open-repair-for-juxtarenal-and-pararenal-aortic-aneurysms-a-propensity-matched-analysis
#18
Nathan T Orr, Daniel L Davenport, David J Minion, Eleftherios S Xenos
OBJECTIVE: Endoluminal aortic aneurysm repair is suitable within certain anatomic specifications. This study aims to compare 30-day outcomes of endovascular versus open repairs for juxtarenal and pararenal aortic aneurysms (JAA/PAAs). METHODS: The ACS-NSQIP database was queried from 2012 to 2015 for JAA/PAA repairs. Procedures characterized as emergent were included in the study; however, failed prior repairs and ruptured aneurysms were excluded. The preoperative and perioperative patient characteristics, operative techniques, and outcome variables were compared between the open aortic repair and the endovascular aortic repair groups...
November 30, 2016: Vascular
https://www.readbyqxmd.com/read/27903486/predictive-models-of-complications-following-endovascular-aortic-aneurysm-repair
#19
Adrien Kaladji, Anne Daoudal, Aurélien Duménil, Cemil Göksu, Alain Cardon, Elodie Clochard, Antoine Lucas, Florent Lalys
BACKGROUND: The risk of long-term complications after endovascular aneurysm repair (EVAR) is still higher than open surgery and is a critical issue. This study aims to make available reliable statistical predictive models of complications after EVAR. METHODS: Two hundred and thirteen patients who underwent EVAR between 2002 and 2012 were included in this study. The preoperative CT-scans were analyzed with a dedicated workstation to provide spatially correct 3-dimensional data...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903485/endovascular-repair-of-thoraco-abdominal-aortic-aneurysm-in-high-surgical-risk-patients-fenestrated-and-branched-endografts
#20
E Gallitto, M Gargiulo, A Freyrie, C Bianchini Massoni, R Pini, C Mascoli, G L Faggioli, S Ancetti, A Stella
AIM: To report early and mid-term results of endovascular repair of thoraco-abdominal aneurysms (TAAA) by using of Cook-Zenith fenestrated/branched endografts (FB-EVAR) in high-surgical risk patients unfit for open repair (OR). METHODS: Between January 2012 and April 2015, all the patients with TAAA, considered at high-surgical risk for OR and treated by Cook-Zenith FB-EVAR, were prospectively enrolled. Patients were studied using a thoraco-abdominal computer tomography angiography (CTA) and dedicated software for advanced vessels analysis...
November 26, 2016: Annals of Vascular Surgery
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