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Sonia Ronchey, Stefano Fazzini, Salvatore Scali, Giovanni Torsello, Paul Kubilis, Frank Veith, Konstantinos P Donas, Felice Pecoraro, Nicola Mangialardi
PURPOSE: The aim of this retrospective analysis was to evaluate the performance of the chimney (ch) technique in the treatment of type Ia endoleaks after standard endovascular aneurysm repair (EVAR). METHODS: Between January 2008 and December 2014, 517 chEVAR procedures were performed in 13 US and European vascular centers (PERICLES registry). Thirty-nine patients (mean age 76.9±7.1 years; 33 men) were treated for persistent type Ia endoleak and had computed tomography angiography or magnetic resonance angiography follow-up at >1 month...
June 1, 2018: Journal of Endovascular Therapy
Mathew Wooster, Paul Armstrong, Martin Back
OBJECTIVE: Maintenance of pelvic circulation has been connected to reduced risks of ischemic colitis, buttock claudication, erectile dysfunction, and spinal cord ischemia during the treatment of extensive aorto-iliac aneurysmal disease. We evaluate the mid to late follow up of a cohort of patients treated using one preservation technique, the endovascular external (EIA) to internal (IIA) iliac artery bypass. METHODS: All patients undergoing elective retrograde EIA-IIA endovascular bypass at a single institution were retrospectively reviewed over a ten-year period from 2006-2016...
June 13, 2018: Annals of Vascular Surgery
Alexander D Leung, Dai Yamanouchi
RATIONALE: In situ fenestration may be necessary to preserve branch arteries during thoracic endovascular aortic repair (TEVAR) when there is an inadequate landing zone. PATIENT CONCERNS: We report the case of a 74-year-old man presenting with recurrent hemoptysis. DIAGNOSES: Based on computed tomography (CT) angiogram and bronchoscopy, diagnosis was aorto-bronchial fistula. INTERVENTIONS: We performed retrograde in situ fenestration with reentry catheter (Pioneer Plus, Volcano Corporation, San Diego, CA) to preserve the left subclavian artery following TEVAR for aorto-bronchial fistula...
June 2018: Medicine (Baltimore)
Sebastian Zerwes, Hans-Kees Bruijnen, Yvonne Gosslau, Rudolf Jakob, Alexander Hyhlik-Dürr
PURPOSE: To evaluate the impact of the revised Nellix instructions for use (IFU) from 2016 on clinical outcomes and anatomic applicability by retrospectively applying them to a cohort treated with endovascular aneurysm sealing according to the original IFU 2013. METHODS: A single-center study was conducted of 100 consecutive patients (mean age 72±8 years, range 46-91; 89 men) treated electively with standard bilateral EVAS from July 2013 to August 2015 and followed through December 2017...
June 1, 2018: Journal of Endovascular Therapy
A S Ribner, A K Tassiopoulos
The abdominal aorta is the most common site of an aortic aneurysm. The visceral and most proximal infrarenal segment (aneurysm neck) are usually spared and considered more resistant to aneurysmal degeneration. However, if an abdominal aortic aneurysm (AAA) is left untreated, the natural history of the aortic neck is progressive dilatation and shortening. This may have significant implications for patients undergoing endovascular repair of AAAs (EVAR) as endograft stability and integrity of the repair are dependent on an intact proximal seal zone...
June 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Koji Maeda, Takao Ohki, Yuji Kanaoka
The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms...
June 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Lixin Wang, Shuangchao Liang, Xin Xu, Bin Chen, Junhao Jiang, Zhenyu Shi, Xiao Tang, Xiushi Zhou, Min Zhou, Daqiao Guo, Weiguo Fu
BACKGROUND: Bell-bottom technique (BBT) is one method to preserve the internal iliac artery during EVAR for abdominal aortic aneurysm(AAA) that extend to iliac artery. The data on the efficacy of this technique is still limited. We sought to evaluate the mid-term efficacy of BBT by using different stent-grafts in the treatment of AAA combined with iliac artery aneurysm (IAA). METHODS: From January 2011 to December 2016, AAA patients with IAA using BBT to preserve the internal iliac artery were retrospectively analyzed in our institution...
June 6, 2018: Annals of Vascular Surgery
Marcin Gabriel, Jolanta Tomczak, Magdalena Snoch-Ziółkiewicz, Łukasz Dzieciuchowicz, Ewa Strauss, Katarzyna Pawlaczyk, Dorota Wojtusik, Grzegorz Oszkinis
PURPOSE: The aim of the study was to assess the effectiveness of Superb Micro-vascular Imaging (SMI) as an alternative to Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography Angiography (CTA) for endoleak detection and classification in patients followed up after endovascular abdominal aortic aneurysm repair (EVAR). MATERIALS AND METHODS: From May 2015 to January 2017, 30 patients underwent post-EVAR follow-up with Color Doppler Ultrasound (CDUS), CEUS, SMI, and CTA examinations...
June 6, 2018: Abdominal Radiology
Rosa Marie Andersen, Daniel P Henriksen, Hossein Mohit Mafi, Sten Langfeldt, Jacob Budtz-Lilly, Ole Graumann
PURPOSE: The aim of this study was to evaluate the incidence, risk factors, and outcome of endoleaks related to endovascular aneurysm repair (EVAR) procedure at a single center with up to 10 years' surveillance. MATERIALS AND METHODS: All patients treated with EVAR for an abdominal aorta or iliac aneurysm in a 10-year period at a single cardiovascular center in Denmark were included. Data were collected from a national database and patient journals. Follow-up computed tomography angiography and plain abdominal X-ray reports were reviewed...
January 1, 2018: Vascular and Endovascular Surgery
Yolanda Bryce, Wonho Kim, Barry Katzen, James Benenati, Shaun Samuels
PURPOSE: To assess differences in outcome in an early and later time period in patients with hostile neck anatomy who underwent endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: This single-center, institutional review board-approved retrospective study assessed patients who underwent EVAR between 2004 and 2013, divided into 2 time periods: 2004-2008 and 2009-2013. One hundred twenty-five patients had at least 1 hostile neck parameter that met inclusion criteria: 61 of 216 (28%) patients in the early period and 64 of 144 (44%) patients in the late period...
May 31, 2018: Journal of Vascular and Interventional Radiology: JVIR
Tomaz Crochemore, Felicio A Savioli
BACKGROUND: Hemorrhagic shock is a medical emergency that often complicates vascular surgery and can lead to death. Hemorrhagic shock is characterized by hypoperfusion and hemodynamic abnormalities leading to the collapse of homeostasis due to massive blood loss. Early diagnosis is critical for a favorable outcome. Thromboelastometry has been considered an effective tool for bleeding management in critically ill patients. Thromboelastometry can guide transfusion therapy quickly, reducing the need for blood products...
June 2, 2018: Journal of Medical Case Reports
Dania Daye, T Gregory Walker
In recent decades, endovascular aneurysm repair or endovascular aortic repair (EVAR) has become an acceptable alternative to open surgery for the treatment of thoracic and abdominal aortic aneurysms and other aortic pathologies such as the acute aortic syndromes (e.g., penetrating aortic ulcer, intramural hematoma, dissection). Available data suggest that endovascular repair is associated with lower perioperative 30-day all-cause mortality as well as a significant reduction in perioperative morbidity when compared to open surgery...
April 2018: Cardiovascular Diagnosis and Therapy
Yolanda Bryce, Brian Schiro, Kyle Cooper, Suvranu Ganguli, Mamdouh Khayat, Cuong Ken Lam, Rahmi Oklu, Geogy Vatakencherry, Ripal T Gandhi
Elective abdominal aortic aneurysm (AAA) repair is recommended for aneurysms greater than 5.5 cm, symptomatic, or rapidly expanding more than 0.5 cm in 6 months. Seventy-five percent of AAAs today are treated with endovascular aneurysm repair (EVAR) rather than open repair. This is fostered by the lower periprocedural mortality, complications, and length of hospital stay associated with EVAR. However, some studies have demonstrated EVAR to result in higher reintervention rates than with open repair, largely due to endoleaks...
April 2018: Cardiovascular Diagnosis and Therapy
Lixin Wang, Kai Hou, Xin Xu, Bin Chen, Junhao Jiang, Zhenyu Shi, Xiao Tang, Daqiao Guo, Weiguo Fu
Background: To report a simple individual tailored aortic arch tangential angle (θ-AATA) measuring method and its clinical application efficacy in the endovascular treatment of type B aortic dissection (AD). Methods: From January 2013 to December 2014, acute type B AD patients were prospectively enrolled and treated with endovascular therapy in our center. Among these patients, a specific method was applied to measure θ-AATA based on the axial images of the CT scan...
April 2018: Journal of Thoracic Disease
Ian Jun Yan Wee, Nicholas Syn, Andrew M T L Choong
The caval-aortic path is a novel access route for endovascular aortic interventions in aortic interventions, particularly for patients unsuitable for traditional access routes including femoral, subclavian, transapical, and aortic. A systematic review was conducted as per the PRISMA guidelines utilizing three electronic databases: Medline, Embase, and Cochrane database. There were 10 studies identified, including 7 retrospective studies, 1 prospective cohort study, and 2 case reports. Data on 209 patients (mean age 79...
May 24, 2018: Journal of Cardiology
Elisabeth Vukovic, Martin Czerny, Friedhelm Beyersdorf, Martin Wolkewitz, Mikolaj Berezowski, Matthias Siepe, Philipp Blanke, Bartosz Rylski
OBJECTIVE: The aim of this study was to define how the proximal landing zone changes geometrically after endovascular abdominal aortic aneurysm repair (EVAR) with the Anaconda (Vascutek, Inchinnan, United Kingdom) stent graft. METHODS: Among 230 patients who underwent Anaconda stent graft implantation between 2005 and 2014, we included 126 with adequate computed tomography (CT) image quality and follow-up. CT analysis entailed the geometric changes in the main body, proximal rings, and proximal landing zone...
May 24, 2018: Journal of Vascular Surgery
Enrico Gallitto, Gianluca Faggioli, Chiara Mascoli, Rodolfo Pini, Stefano Ancetti, Andrea Vacirca, Andrea Stella, Mauro Gargiulo
BACKGROUND: Thoracoabdominal aortic aneurysms (TAAAs) after previous aortic open surgical repair (OSR) are challenging clinical scenarios. Redo-OSR is technically demanding, and standard endovascular repair is unavailable due to visceral vessel involvement. Fenestrated and branched endografts (FB-EVAR) are effective options to treat TAAAs in high surgical risk patients but dedicated studies on the FB-EVAR outcomes in patients with TAAAs with previous OSR are not available. The aim of the study was to evaluate the impact of previous OSR on TAAAs FB-EVAR outcomes...
May 24, 2018: Journal of Vascular Surgery
Katherine M Stenson, Benjamin O Patterson, Matthew Joe Grima, Jorg L De Bruin, Peter J E Holt, Ian Loftus
BACKGROUND: Endovascular aneurysm sealing (EVAS) represents a novel approach to the treatment of abdominal aortic aneurysms. It uses polymer technology to achieve an anatomic seal within the sac of the aneurysm. This cohort study reports the early clinical outcomes, technical refinements, and learning curve during the initial EVAS experience at a single institution. METHODS: Results from 150 consecutive EVAS cases for intact, infrarenal abdominal aortic aneurysms are reported here...
May 24, 2018: Journal of Vascular Surgery
Blandine Maurel, Teresa Martin-Gonzalez, Debra Chong, Andrew Irwin, Guillaume Guimbretière, Meryl Davis, Tara M Mastracci
OBJECTIVE: Use of three-dimensional fusion has been shown to significantly reduce radiation exposure and contrast material use in complex (fenestrated and branched) endovascular aneurysm repair (EVAR). Cydar software (CYDAR Medical, Cambridge, United Kingdom) is a cloud-based technology that can provide imaging guidance by overlaying preoperative three-dimensional vessel anatomy from computed tomography scans onto live fluoroscopy images both in hybrid operating rooms and on mobile C-arms...
May 24, 2018: Journal of Vascular Surgery
William Shutze, Velipekka Suominem, William Jordan, Piergiorgio Cao, Steven Oweida, Ross Milner
BACKGROUND: The Gore Global Registry for Endovascular Aortic Treatment (GREAT) was designed to evaluate real-world outcomes after treatment with Gore aortic endografts used in a real-world, global setting. We retrospectively analyzed the GREAT data to evaluate the incidence and effects of noncylindrical neck anatomy in patients undergoing endovascular aortic aneurysm repair. METHODS: The present analysis included patients with data in the GREAT who had been treated with the EXCLUDER endograft from August 2010 to October 2016...
May 23, 2018: Journal of Vascular Surgery
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