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Endovascular aneurysm repair

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https://www.readbyqxmd.com/read/28648757/prolonged-icu-length-of-stay-after-aaa-repair-analysis-of-time-trends-and-long-term-outcome
#1
H Gavali, K Mani, G Tegler, R Kawati, L Covaciu, A Wanhainen
OBJECTIVE: The aim of the study was to investigate the frequency and outcome of prolonged intensive care unit (ICU) length of stay (LOS) after abdominal aortic aneurysm (AAA) repair in the endovascular era. METHODS: All patients operated on for AAA between 1999 and 2013 at Uppsala University hospital were identified. Data were retrieved from the Swedish Vascular registry, the Swedish Intensive Care registry, the National Population registry, and case records. Prolonged ICU LOS was defined as ≥ 48 h during the primary hospital stay...
June 22, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#2
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648481/outcomes-of-concomitant-renal-reconstruction-during-open-paravisceral-aortic-aneurysm-repair
#3
Mathew Wooster, Martin Back, Shivangi Patel, Adam Tanious, Paul Armstrong, Murray Shames
OBJECTIVE: The objective of this study was to review the outcomes of renal artery revascularizations during open aortic aneurysm repair. METHODS: Open abdominal aneurysm repairs performed from 2010 to 2015 at a single institution were reviewed, including type IV thoracoabdominal, suprarenal, and juxtarenal aneurysms. Direct renal reconstruction techniques included eversion endarterectomy, bypass, and vessel reimplantation based on the patient's anatomy. Renal loss was defined by artery occlusion...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647340/a-simulator-for-training-in-endovascular-aneurysm-repair-the-use-of-three-dimensional-printers
#4
I O Torres, N De Luccia
OBJECTIVES: To develop an endovascular aneurysm repair (EVAR) simulation system using three dimensional (3D) printed aneurysms, and to evaluate the impact of patient specific training prior to EVAR on the surgical performance of vascular surgery residents in a university hospital in Brazil. METHODS: This was a prospective, controlled, single centre study. During 2015, the aneurysms of patients undergoing elective EVAR at São Paulo University Medical School were 3D printed and used in training sessions with vascular surgery residents...
June 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#5
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647036/supra-aortic-interventions-for-endovascular-exclusion-of-the-entire-aortic-arch
#6
REVIEW
Terézia B Andrási, Marius Grossmann, Dieter Zenker, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVE: Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. METHODS: Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28644100/influence-of-smoking-on-aneurysm-recurrence-after-endovascular-treatment-of-cerebrovascular-aneurysms
#7
John Futchko, Jordan Starr, Darryl Lau, Matthew R Leach, Christopher Roark, Aditya S Pandey, B Gregory Thompson
OBJECTIVE Smoking is a known risk factor for aneurysm development and aneurysmal subarachnoid hemorrhage, as well as subsequent vasospasm in both untreated individuals and patients who have undergone surgical clipping of cerebrovascular aneurysms. However, there is a lack of data in the current scientific literature about the long-term effects that smoking has on the integrity of endovascular repairs of cerebral aneurysms. This study was designed to determine if any smoking history increased the risk of poorer outcomes and/or aneurysm recurrence in patients who have had endovascular repair of cerebral aneurysms...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28642793/repair-of-thoracoabdominal-aortic-aneurysm-with-thrombosed-infrarenal-component-a-modified-hybrid-technique-without-aortic-cross-clamping
#8
Hussam Abou-Al-Shaar, Khaled J Zaza, Muhammad Anees Sharif, Samer Koussayer
The authors report the successful repair of a Crawford type III thoracoabdominal aortic aneurysm (TAAA) with a thrombosed infrarenal component using a modified hybrid technique without aortic clamping in a high-risk patient. A 64-year-old male with a history of hypertension, diabetes, and severe chronic obstructive pulmonary disease presented with acute on chronic backache and bilateral short distance claudication. A computerized tomography scan demonstrated a large, nonleaking Crawford type III TAAA with thrombosed infrarenal component of the aneurysm...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#9
C Anibueze, V Sankaran, U Sadat, K Tan, Y G Wilson, R E Brightwell, M S Delbridge, P W Stather
OBJECTIVE: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra anatomical bypass grafting; however use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic haemorrhage, limb occlusion and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 19, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28639918/midterm-analysis-of-survival-and-cause-of-death-following-endovascular-abdominal-aortic-aneurysm-repair
#10
Gerard M Healy, Ciaran E Redmond, Sam Gray, Lucian Iacob, Stephen Sheehan, Joseph F Dowdall, Mary Barry, Colin P Cantwell, David P Brophy
PURPOSE: To assess rates of complications, secondary interventions, survival, and cause of death following endovascular abdominal aortic aneurysm (AAA) repair over a 10-year period. MATERIALS AND METHODS: Single-institution retrospective cohort study of all patients undergoing primary endovascular aortic aneurysm repair (EVAR) between July 2006 and June 2015. The population constituted 175 patients with 163 fusiform and 12 saccular AAAs. Of these, 149 (85%) were male, with mean age 75...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28638973/a-retrospective-observational-cohort-study-investigating-the-association-between-acute-kidney-injury-and-all-cause-mortality-among-patients-undergoing-endovascular-repair-of-abdominal-aortic-aneurysms
#11
Kimito Minami, Yoko Sugiyama, Hiroki Iida
BACKGROUND: Acute kidney injury (AKI) has been found to be associated with short- and long-term mortality and morbidity in various clinical settings. However, it is unknown whether AKI after endovascular repair of abdominal aortic aneurysms (EVAR) is associated with postoperative mortality. METHODS: This observational study analyzed patients who underwent EVAR. The primary outcome was all-cause mortality. The outcomes of patients with and without postoperative AKI were compared using the Kaplan-Meier method and log-rank test...
June 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28638171/3d-printed-abdominal-aortic-aneurysm-phantom-for-image-guided-surgical-planning-with-a-patient-specific-fenestrated-endovascular-graft-system
#12
Karen M Meess, Richard L Izzo, Maciej L Dryjski, Richard E Curl, Linda M Harris, Michael Springer, Adnan H Siddiqui, Stephen Rudin, Ciprian N Ionita
Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28634567/aaa-rupture-and-psoas-hematoma-due-to-type-ii-endoleak-from-inferior-mesenteric-artery-unusual-collaterals
#13
Panagiotis G Theodoridis, Dimitrios N Staramos, Nikolaos Ptochis, Ioannis A Papailiou, Ilias Dodos, Nikolaos Iatrou, Anastasios G Potouridis, Konstantinos Dervisis
Although endovascular aneurysm repair (EVAR) in the abdominal aorta has reduced the perioperative mortality when compared with open repair, the need for reintervention after complications such as endoleak may be presented in up to 20% of the cases. Type II endoleak from branch vessels is often benign but can potentially be associated with progressive abdominal aortic aneurysm growth and sac expansion. We present a rare case of a patient who presented with sac expansion and psoas hematoma due to Type II endoleak from "unusual" collaterals of IMA and was treated successfully with endoleak microembolization and percutaneous decompression of the hematoma...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28634431/the-aftermath-of-a-hepatic-artery-aneurysm-a-rare-etiology-of-biliary-obstruction
#14
Catherine Linzay, Abhishek Seth, Kunal Suryawala, Ankur Sheth, Moheb Boktor, John Bienvenu, Robby Rahim, Guillermo P Sangster, Paul A Jordan
BACKGROUND: Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported. CASE PRESENTATION: A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin...
2017: Clinical Medicine Insights. Gastroenterology
https://www.readbyqxmd.com/read/28633519/changes-in-abdominal-aortic-aneurysm-epidemiology
#15
Fredrik Lilja, Anders Wanhainen, Kevin Mani
INTRODUCTION: The epidemiology and treatment of abdominal aortic aneurysms (AAA) has changed over the past 30 years. EVIDENCE ACQUISITION: This review aims to give the reader an overview of these changes and current trends in AAA epidemiology, management and outcome. EVIDENCE SYNTHESIS: In the past decades there have been three changes in AAA management and epidemiology: a) introduction of endovascular aortic repair (EVAR), b) population screening and c) a markedly reduced prevalence of the disease...
June 20, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28633258/stepwise-total-aortic-repairs-with-fenestrated-endografts-in-a-patient-with-loeys-dietz-syndrome
#16
Kenichi Hashizume, Hideyuki Shimizu, Masanori Honda, Shinya Inoue, Hidenobu Takaki, Kanako Hayashi, Hiroaki Kaneyama
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder (CTD) caused by mutations in the gene encoding transforming growth factor-β receptors Ⅰ and Ⅱ. Patients with LDS manifest spontaneous aneurysms and dissections of the aorta and peripheral artery. We report a successful treatment with a hybrid endovascular repair for a rapidly expanding thoracoabdominal aneurysm in a 41-year-old woman affected by LDS. To overcome the difficulties of anatomical and surgical repair, we applied an original strategy using surgeon-modified fenestrated endografts...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#17
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28627864/type-ii-endoleaks-when-and-how
#18
Matthew J Grima, Alan Karthikesalingam
Although most type II endoleaks are self-limiting, the most common indication for secondary intervention after endovascular aneurysm repair (EVAR) is type II endoleak. However, it is still debatable when to treat them. Furthermore, different intervention techniques are available to treat type II endoleaks. The aim of this review is to look at current evidence and updates on type II endoleaks after EVAR for abdominal aortic aneurysm and their management.
June 19, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28627863/endovascular-treatment-of-mycotic-aortic-aneurysms-a-paradigm-shift
#19
Karl Sörelius, Kevin Mani, Martin Björck, Anders Wanhainen
Treatment of mycotic aortic aneurysms (MAA) composes a particularly difficult challenge. Open repair (OR) has been considered the gold standard, despite lack of evidence supporting its superiority compared with the emerging alternative endovascular aortic repair (EVAR). This review discusses the pros and cons of EVAR for MAAs by dissecting the three largest publications on MAAs, and concludes that there has been a paradigm shift in treatment of MAAs for the benefit of EVAR.
June 19, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28623454/-erratum-to-hybrid-operating-rooms-versus-conventional-operating-rooms-economic-comparisons-in-vascular-surgery-using-the-example-of-endovascular-aneurysm-repair
#20
N Attigah, S Demirel, M Hakimi, H Bruijnen, O Schöffski, A Müller, U Geis, D Böckler
No abstract text is available yet for this article.
June 16, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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