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https://www.readbyqxmd.com/read/28202161/complication-profile-failure-to-rescue-and-mortality-following-elective-endovascular-aortic-aneurysm-repair
#1
David S Kauvar, Eric D Martin, Todd E Simon, Matthew D Givens
INTRODUCTION: Understanding the relationship between patient risk factors, postoperative complications, and morbidity and mortality is important when considering elective endovascular aortic aneurysm repair (E-EVAR) performed to prevent aneurysm rupture mortality. We aimed to stratify complications in E-EVAR and explore their relationship with postoperative death. METHODS: E-EVAR cases from 2012 NSQIP were identified. 30-day complications were categorized as major (MAJCX) or minor (MINCX) using the Clavien-Dindo classification...
February 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28198175/early-intervention-effects-of-or-and-evar-on-young-patients-suffering-from-40-54mm-aaas-single-center-experience
#2
Jian Qui, Chang Shu, Wenwu Cai, Ming Li, Quanming Li
BACKGROUND: We conducted this study to explore the early intervention effects of OR and EVAR in treating young AAA patients (maximum diameter 40~54mm). METHODS: We retrospectively analyzed patients under 65 years old with maximum AAA diameter 40-54mm in our hospital from Jan. 2010 to Jan. 2016 (among which there are 38 EVAR cases and 18 OR cases) and compared their short-mid term operation effects. RESULTS: The time of the operation, bleeding volume and volume of blood transfusion during operation in the EVAR group are significantly lower than those in the OR group; differences are statistically significant (P<0...
February 14, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28196614/safety-and-efficacy-of-embolization-using-onyx-%C3%A2-of-persistent-type-ii-endoleaks-after-abdominal-endovascular-aneurysm-repair
#3
C Marcelin, Y Le Bras, F Petitpierre, D Midy, E Ducasse, N Grenier, F Cornelis
PURPOSE: To retrospectively evaluate the safety and efficacy of embolization of persistent type II endoleaks occurring after abdominal endovascular aneurysm repair (EVAR) using ethylene vinyl alcohol copolymer (Onyx(®)). MATERIAL AND METHODS: Between 2008 and 2016, 28 consecutives patients (25 men, 3 women) with a mean age of 75.3years±9 (SD) (range: 59-90years) were treated for 29 persistent type II endoleaks with increasing aneurysm size>5mm occurring after EVAR...
February 10, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28190716/five-year-outcomes-of-the-pythagoras-u-s-clinical-trial-of-the-aorfix-endograft-for-endovascular-aneurysm-repair-in-patients-with-highly-angulated-aortic-necks
#4
Mahmoud B Malas, Caitlin W Hicks, William D Jordan, Kim J Hodgson, Joseph L Mills, Michel S Makaroun, Michael Belkin, Mark F Fillinger
OBJECTIVE: Early and midterm outcomes of the Prospective Aneurysm Trial: High Angle Aorfix Bifurcated Stent Graft (PYTHAGORAS) trial in patients with highly angulated aortic necks (≥60 degrees) have already been published and shown comparable outcomes to other endografts in normal anatomy. Herein, we present the long-term outcomes of the PYTHAGORAS trial of Aorfix (Lombard Medical, Irvine, Calif) for patients with highly angulated aortic neck anatomy. METHODS: The Aorfix endograft is a highly conformable nitinol/polyester device designed for transrenal fixation...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190712/effect-of-antiplatelet-therapy-on-aneurysmal-sac-expansion-associated-with-type-ii-endoleaks-after-endovascular-aneurysm-repair
#5
Francisco Álvarez Marcos, José Manuel Llaneza Coto, Francisco José Franco Meijide, Ahmad Amer Zanabili Al-Sibbai, Jorge Vilariño Rico, Manuel Alonso Pérez, Santiago Caeiro Quinteiro
OBJECTIVE: Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) has gained widespread use through a solid reputation of safety and effectiveness. However, some issues, such as endoleaks and sac growth over time, still arise as important concerns. Antiplatelet therapy, mandatory as secondary prevention of cardiovascular disease, may play a role in both phenomena by interfering with blood clotting properties and the inflammatory process associated with AAA. We analyzed whether different antiplatelet therapies were independent risk factors for type II endoleak (T2E) persistence and midterm sac growth after EVAR...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190708/predictive-factors-for-additional-proglide-deployment-in-percutaneous-endovascular-aortic-repair
#6
Shen-Yen Lin, Sin-Yi Lyu, Ta-Wei Su, Sung-Yu Chu, Chien-Ming Chen, Chien-Fu Hung, Chee-Jen Chang, Po-Jen Ko
PURPOSE: To evaluate outcomes and predictive factors for additional ProGlide device deployment in percutaneous endovascular aortic repair (PEVAR) with the preclose technique. MATERIALS AND METHODS: Clinical data of patients who underwent PEVAR with the preclose technique from February 2012 to January 2015 were retrospectively reviewed. A total of 268 patients (229 men, 39 women) who underwent PEVAR (thoracic endovascular aortic repair [TEVAR], n = 113; endovascular abdominal aortic repair [EVAR], n = 152; simultaneous TEVAR and EVAR, n = 3) with 418 femoral access sites were enrolled...
February 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28182753/prevalence-and-risk-factors-of-type-ii-endoleaks-after-endovascular-aneurysm-repair-a-meta-analysis
#7
Qiang Guo, Xiaojiong Du, Jichun Zhao, Yukui Ma, Bin Huang, Ding Yuan, Yi Yang, Guojun Zeng, Fei Xiong
OBJECTIVES: This systematic review and meta-analysis aims to determine the current evidence on risk factors for type II endoleaks after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: A systematic literature search was carried out for studies that evaluated the association of demographic, co-morbidity, and other patient-determined factors with the onset of type II endoleaks. Pooled prevalence of type II endoleaks after EVAR was updated. RESULTS: Among the 504 studies screened, 45 studies with a total of 36,588 participants were included in this review...
2017: PloS One
https://www.readbyqxmd.com/read/28164730/safety-and-efficacy-of-totally-percutaneous-access-compared-with-open-femoral-exposure-for-endovascular-aneurysm-repair
#8
Zhanjiang Cao, Weiwei Wu, Keqiang Zhao, Junlai Zhao, Yu Yang, Chao Jiang, Rongrong Zhu
PURPOSE: To compare the safety and efficacy of percutaneous (PEVAR) vs open femoral access (OFA) techniques for endovascular aneurysm repair (EVAR). METHODS: A systematic review of English-language articles (Medline, EMBASE, and Cochrane databases) between January 1999 and August 2016 returned 11 studies including 1650 patients with 2500 groin accesses eligible for the meta-analysis. Data extracted from each study were synthesized to evaluate technical success rates, procedure time, and complications for the 2 access approaches...
February 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28163181/treatment-of-an-aortic-arch-aneurysm-with-scalloped-and-fenestrated-thoracic-stent-graft-and-left-carotid-to-subclavian-artery-bypass
#9
Cheow Soon Chia, Luke Tay Hsien Tsung, John Wang Chaw Chian, Tze Tec Chong, Kiang Hiong Tay, Edward Choke Tieng Chek
We report a successful treatment of thoracic arch aneurysm using a combination of hybrid approach and a customized stent graft in a frail patient with challenging anatomy and concomitant large retrosternal goiter. The patient is an 82-year-old lady with multiple comorbidities who presented to her general practitioner for anorexia and significant weight loss. She was incidentally found to have a 6.6 cm saccular distal aortic arch aneurysm, a 5.5 cm infrarenal abdominal aortic aneurysm, and a large goiter adjacent to the left common carotid artery with retrosternal extension...
February 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28163175/thrombosis-of-the-inferior-vena-cava-after-endovascular-aortic-repair-in-a-patient-with-may-thurner-syndrome-case-report-and-literature-review
#10
Firouza Dahi, Asimakis Gkremoutis, Marc Harth, Thomas Schmitz-Rixen, Michael Keese
Inferior vena cava (IVC) thrombosis is a rare complication of abdominal aortic aneurysm (AAA). A 70-year-old male patient of Italian origin presented with a 9.3 x 8.4 cm infrarenal AAA, which was treated by endovascular aortic repair (EVAR). He reported a history of ulcerative colitis and was on prednisolone 80 mg daily. Seven weeks postoperatively the patient was readmitted with a deep vein thrombosis including both iliac veins and IVC, and bilateral pulmonary embolism. Venous thrombectomy and decompression of the IVC was performed by partial resection of the aneurysm sac...
February 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28161566/monocentric-evaluation-of-chimney-versus-fenestrated-endovascular-aortic-repair-for-juxta-renal-abdominal-aortic-aneurysm
#11
Caroline Caradu, Julien Morin, Mathieu Poirier, Dominique Midy, Eric Ducasse
BACKGROUND: With approval of on-label fenestrated (F-) endovascular aortic repair (EVAR), concerns regarding long-term patency and endoleaks (ELs) after chimney graft (CG)-EVAR were raised. To add supportive data on the value of this technique, we chose to report the mid-term results of CG-EVAR in a single center with standardized methods and to compare them to F-EVAR. METHODS: A retrospective analysis of prospectively gathered data from January 2010 to January 2015 was conducted and patients with excessive comorbidities for open repair treated by CG-EVAR or F-EVAR were included...
February 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28160528/meta-analysis-of-individual-patient-data-from-evar-1-dream-over-and-ace-trials-comparing-outcomes-of-endovascular-or-open-repair-for-abdominal-aortic-aneurysm-over-5-years
#12
REVIEW
J T Powell, M J Sweeting, P Ulug, J D Blankensteijn, F A Lederle, J-P Becquemin, R M Greenhalgh
BACKGROUND: The erosion of the early mortality advantage of elective endovascular aneurysm repair (EVAR) compared with open repair of abdominal aortic aneurysm remains without a satisfactory explanation. METHODS: An individual-patient data meta-analysis of four multicentre randomized trials of EVAR versus open repair was conducted to a prespecified analysis plan, reporting on mortality, aneurysm-related mortality and reintervention. RESULTS: The analysis included 2783 patients, with 14 245 person-years of follow-up (median 5·5 years)...
February 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28155691/influence-of-endoleak-positions-on-the-pressure-shielding-ability-of-stent-graft-after-endovascular-aneurysm-repair-evar-of-abdominal-aortic-aneurysm-aaa
#13
Jie Li, Xiaopeng Tian, Zhenze Wang, Jiang Xiong, Yubo Fan, Xiaoyan Deng, Anqiang Sun, Xiao Liu
BACKGROUND: Abdominal aortic aneurysm (AAA) is a kind of dangerous aortic vascular disease, which is characterized by abdominal aorta partial enlargement. At present, endovascular aneurysm repair (EVAR) is one of the main treatments of abdominal aortic aneurysm. However for some patients after EVAR the aneurysm re-expanded and even ruptured, leading to poor postoperative effect. The stent-graft endoleak after EVAR was realized to influence the AAA in-sac pressure and contribute to the aneurysm re-enlargement...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28154297/outcomes-of-endovascular-repair-of-aortoiliac-aneurysms-and-analyses-of-anatomic-suitability-for-internal-iliac-artery-preserving-devices-in-japanese-patients
#14
Nathan K Itoga, Naoki Fujimura, Keita Hayashi, Hideaki Obara, Hideyuki Shimizu, Jason T Lee
BACKGROUND: Understanding that the common iliac arteries (CIA) are shorter in Asian patients, we investigated whether this anatomic difference affects the clinical outcomes of internal iliac artery (IIA) exclusion during endovascular aneurysm repair (EVAR) of aortoiliac aneurysm and thus limits the use of IIA-preserving devices in Japanese patients.Methods and Results:From 2008 to 2014, 69 Japanese patients underwent EVAR of aortoiliac aneurysms with 53 unilateral and 16 bilateral IIA exclusions...
February 2, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28139092/the-role-of-learning-in-health-technology-assessments-an-empirical-assessment-of-endovascular-aneurysm-repairs-in-german-hospitals
#15
Yauheniya Varabyova, Carl Rudolf Blankart, Jonas Schreyögg
Changes in performance due to learning may dynamically influence the results of a technology evaluation through the change in effectiveness and costs. In this study, we estimate the effect of learning using the example of two minimally invasive treatments of abdominal aortic aneurysms: endovascular aneurysm repair (EVAR) and fenestrated EVAR (fEVAR). The analysis is based on the administrative data of over 40,000 patients admitted with unruptured abdominal aortic aneurysm to more than 500 different hospitals over the years 2006 to 2013...
February 2017: Health Economics
https://www.readbyqxmd.com/read/28128541/fenestrated-and-chimney-endovascular-aneurysm-repair-versus-open-surgery-for-complex-abdominal-aortic-aneurysms
#16
Vicente A Sala-Almonacil, José M Zaragozá-García, Mauricio Ramírez-Montoya, Vicente Molina-Nácher, Inmaculada Martínez-Perelló, Francisco J Gómez-Palonés
BACKGROUND: Many patients with complex abdominal aortic aneurysms are unfit for open repair. New endovascular technologies and bailout techniques are being used for managing those complex anatomies. The purpose of this study is to compare the results obtained with advanced endovascular aneurysm repair techniques (fenestrated and chimney endografts) to those obtained with open repair for the treatment of complex abdominal aortic aneurysms not anatomically suitable for standard endovascular exclusion (infrarenal neck <10 mm, juxtarenal, suprarenal and Crawford's type IV thoracoabdominal aneurysms)...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28127120/results-of-repair-of-iliac-artery-aneurysms-with-the-sandwich-technique
#17
Ryan A Shutze, Wes Oglesby, Allen Lee, William P Shutze
Patients undergoing endovascular repair (EVAR) of aortoiliac or iliac artery aneurysm may require sacrifice of one or both internal iliac arteries (IIAs). Until Food and Drug Administration-approved commercial grafts became available, endovascular IIA preservation was accomplished using the "sandwich" technique, but limited information is available regarding the results of this method. After obtaining institutional review board approval, we identified patients undergoing IIA preservation with the sandwich technique during EVAR at our institution...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28126173/early-and-midterm-outcomes-after-transcatheter-embolization-of-type-i-endoleaks-in-25-patients
#18
Seyed Ameli-Renani, Vyzantios Pavlidis, Robert A Morgan
OBJECTIVE: This study reports the technical success and follow-up results of transcatheter embolization of type I endoleak (ELI) in 25 patients after endovascular aortic repair (EVAR). METHODS: Twenty-five patients with ELI (20 men, five women; mean age 80 years; range, 64-96 years) underwent embolization of abdominal ELI (23 proximal, 2 distal endoleaks) after EVAR. All patients were unsuitable for standard endovascular methods for treatment of ELI. The average aneurysm sac size before embolization was 8...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28126172/effect-of-%C3%AE-blocker-on-aneurysm-sac-behavior-after-endovascular-abdominal-aortic-repair
#19
Wonho Kim, Ripal T Gandhi, Constantino S Peña, Raul E Herrera, Melanie B Schernthaner, Athanassios Tsoukas, Juan M Acuña, Barry T Katzen
OBJECTIVE: This study was conducted to determine whether β-blocker (BB) therapy is associated with abdominal aortic aneurysm (AAA) sac regression after endovascular abdominal aortic repair (EVAR). METHODS: A total of 198 patients (mean age, 76 years) who underwent EVAR were analyzed (104 in the BB group and 94 in the non-BB group). The primary end point was the incidence of AAA sac regression at 1 and 2 years. RESULTS: Hypertension, coronary artery disease, and hyperlipidemia were more common in the BB group...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28118783/computerized-tomography-angiography-by-direct-intra-aortic-low-volume-contrast-injection-in-patients-being-evaluated-for-evar
#20
Pedro Gr Teixeira, Leonardo C Clavijo, Alison G Wilcox, Fred A Weaver
Background Computerized tomography angiography is an important tool for endovascular repair of abdominal aortic aneurysm planning. This study aimed to evaluate the utility of computerized tomography angiography using direct intra-aortic injection of low volume of iodinated contrast in patients being considered for endovascular repair of abdominal aortic aneurysm. Design A 5F high-flow angiographic catheter was positioned in the mid-thoracic aorta through femoral percutaneous access. Computerized tomography angiography was performed with image acquisition starting simultaneously with power injection of 10 mL of iopamidol 76% diluted with normal saline to 50 mL, at 6 mL/s through the angiographic catheter...
January 1, 2017: Vascular
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