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Mark Ajalat, Russell Williams, Samuel E Wilson
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
K K Bredahl, M Taudorf, L Lönn, K C Vogt, H Sillesen, J P Eiberg
OBJECTIVE/BACKGROUND: Surveillance after endovascular aortic aneurysm repair (EVAR) is mandatory and computed tomography angiography (CTA) is considered the standard imaging modality, although patients are exposed to ionizing radiation and nephrotoxic contrast medium. The primary aim of this study was to determine the diagnostic efficacy of duplex ultrasound (DUS) and contrast enhanced ultrasound (CEUS) using CTA as the gold standard. The secondary aim was to determine the clinical consequences of endoleaks missed by DUS and CEUS, or CTA...
October 16, 2016: European Journal of Vascular and Endovascular Surgery
J J Jiang, H K Qing, X M Zhang, X M Zhang, W Li, C Y Shen, Q L Li, Y Jiao
OBJECTIVE: To compare total percutaneous access using preclose technique with femoral artery cut-down in endovascular aneurysm repair (EVAR) and assess the safety and feasibility of preclose technique. METHODS: In the study, 81 cases undergoing EVAR from Dec. 2011 to Nov. 2014 in Peking University People's Hospital were retrospectively reviewed. Preoperative CT angiography (CTA) showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Simon P Overeem, Johannes T Boersen, Richte C L Schuurmann, Erik Groot Jebbink, Cornelis H Slump, Michel M P J Reijnen, Jean-Paul P M de Vries
OBJECTIVE: Gutters can be described as the loss of continuous apposition between the main body of the endograft, the chimney stent graft, and the aortic wall. Gutters have been associated with increased risk of type IA endoleaks and are considered to be the Achilles' heel of chimney endovascular aneurysm repair (ch-EVAR). However, there is no classification yet to classify and quantify gutter types after ch-EVAR. METHODS: Different gutter types can be distinguished by their morphologic appearance in two- and three-dimensional views and reconstructed slices perpendicular to the center lumen line...
October 12, 2016: Journal of Vascular Surgery
Anahita Dua, Steven Koprowski, Gilbert Upchurch, Cheong J Lee, Sapan S Desai
BACKGROUND: In 2014, we published a series of articles in the Journal of Vascular Surgery that detailed the decrease in volume of open aneurysm repair (OAR) completed for abdominal aortic aneurysm (AAA) by vascular surgery trainees. At that time, only data points from 2000 through 2011 were available, and reliable predictions could only be made through 2015. Lack of data on endovascular aneurysm repair (EVAR) using fenestrated (FEVAR) and branched (BrEVAR) endografts also affected our findings...
October 12, 2016: Journal of Vascular Surgery
Rajesh Patel, Michael J Sweeting, Janet T Powell, Roger M Greenhalgh
BACKGROUND: Short-term survival benefits of endovascular aneurysm repair (EVAR) versus open repair of intact abdominal aortic aneurysms have been shown in randomised trials, but this early survival benefit is lost after a few years. We investigated whether EVAR had a long-term survival benefit compared with open repair. METHODS: We used data from the EVAR randomised controlled trial (EVAR trial 1), which enrolled 1252 patients from 37 centres in the UK between Sept 1, 1999, and Aug 31, 2004...
October 12, 2016: Lancet
Isabelle Van Herzeele, Frank Vermassen
No abstract text is available yet for this article.
October 12, 2016: Lancet
Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara
We herein report a case of a rare complication of spinal cord ischemia (SCI) following endovascular aneurysm repair (EVAR). Computed tomography showed stenosis and calcification of bilateral iliac arteries and a saccular aneurysm of the terminal aorta. Paraplegia occurred soon after balloon angioplasty of iliac arteries and EVAR. Cerebrospinal fluid drainage was not performed because the patient was on dual antiplatelet drugs. The patient was treated with intravenous methylpredonisolone and naloxone; however, this did not improve his paraplegia...
2016: Annals of Vascular Diseases
Yukihisa Ogawa, Hiroshi Nishimaki, Kiyoshi Chiba, Kenji Murakami, Yuka Sakurai, Keishi Fujiwara, Takeshi Miyairi, Yasuo Nakajima
A woman in her 80s with an infrarenal aortic aneurysm was scheduled for endovascular aortic repair (EVAR). The aneurysm had a severely angulated neck (SAN), and the Zenith Flex device was selected. Completion angiography showed migration of the main body resulting in right renal artery stenosis. A Palmaz genesis was placed across the renal orifice. The patient had no renal dysfunction and was discharged 7 days after EVAR. If Zenith Flex devices are used for a SAN, it is necessary to consider not only the position of the renal artery but also the appropriate position of the stent-graft...
2016: Annals of Vascular Diseases
Georgios Vourliotakis, Panagiotis G Theodoridis, Stylianos Pikis, Vasileios D Tzilalis
In the modern endovascular era, abdominal aortic aneurysm repair is still not free of complications with re-interventions following endovascular aneurysm repair (EVAR) being more common than with open surgical repair. A variety of endovascular, open surgical and combined techniques were described according to the anatomical considerations and general health of the patient to achieve the best possible result after these complications. In cases of type Ib endoleak following aorto-uni-lateral EVAR for an abdominal aortic aneurysm, the use of the internal branched device (IBD) constitutes a safe and effective technique...
2016: Annals of Vascular Diseases
Kazuto Maruta, Atsushi Aoki, Tadashi Omoto, Hirofumi Iizuka, Hiroyuki Kawaura
Objectives: Unexpected systemic inflammatory response with high fever and increase in C-reactive protein (CRP) occurred frequently after endovascular abdominal aortic aneurysm repair (EVAR). This excessive inflammatory response affects the postoperative course. We evaluated the effects of steroid on the postoperative inflammatory response after EVAR. Methods: Steroid therapy, intravenous infusion of methylprednisolone 1000 mg just after the anesthesia induction, was started since December 2012. After induction of the steroid therapy, 25 patients underwent EVAR with steroid therapy (Group S)...
2016: Annals of Vascular Diseases
Sam Taylor, Ian Thomson, Jo Krysa
AIM: A ruptured abdominal aortic aneurysm (rAAA) remains a significant threat to life, with a 30-50% in-hospital mortality rate. The recent introduction of emergency endovascular aneurysm repair (rEVAR) in New Zealand presents an alternative to open repair for rAAAs. The aim of this paper is to review the current experience in New Zealand in the repair of rAAAs. METHODS: Data from the Australasian Vascular Audit (AVA) was reviewed, with data pertaining to rAAAs collected for the five-year period from January 2010 to December 2014...
October 14, 2016: New Zealand Medical Journal
Luca Ferretto, Sandro Irsara
PURPOSE: To describe a sac embolization technique modification for type II endoleak prevention that makes a totally percutaneous approach feasible during endovascular aneurysm repair (EVAR) using the Excluder stent-graft. TECHNIQUE: Percutaneous access of the common femoral arteries is obtained and 2 suture-mediated closure systems are placed on each side. A 16-F or 18-F sheath is placed for delivery of the Excluder stent-graft main body and a 16-F sheath is used on the contralateral side...
October 12, 2016: Journal of Endovascular Therapy
Minsu Kim, Myeong Gun Kim, Woong Chol Kang, Pyung Chun Oh, Ji Yeon Lee, Jin Mo Kang, Wook-Jin Chung, Eak Kyun Shin
Endovascular aneurysm repair (EVAR) is a safe alternative to open surgical repair for an abdominal aortic aneurysm. However, unfavorable aortic anatomy of the aneurysm has restricted the widespread use of EVAR. Anatomic limitation is most often related to characteristics of the proximal neck anatomy. In this report, we described a patient with a severely angulated proximal neck who underwent EVAR, but required repeat intervention because of thrombotic occlusion of stent graft limbs.
September 2016: Korean Circulation Journal
Xavier Chaufour, Julien Gaudric, Yann Goueffic, Réda Hassen Khodja, Patrick Feugier, Sergei Malikov, Guillaume Beraud, Jean-Baptiste Ricco
OBJECTIVE: Endovascular aneurysm repair (EVAR) is widely used with excellent results, but its infectious complications can be devastating. In this paper, we report a multicenter experience with infected EVAR, symptoms, and options for explantation and their outcome. METHODS: We have reviewed all consecutive endograft explants for infection at 11 French university centers following EVAR, defined as index EVAR, from 1998 to 2015. Diagnosis of infected aortic endograft was made on the basis of clinical findings, cultures, imaging studies, and intraoperative findings...
October 5, 2016: Journal of Vascular Surgery
Ayesha Noorani, Umar Sadat, Katherine E Rollins, Mohammed M Chowdhury, Tjun Y Tang, Seamus C Harrison, Ammara Usman, Keith Burling, Anthony Nordon, Jonathan R Boyle
Acute kidney injury (AKI) is a recognized complication post-endovascular aneurysm repair (EVAR). Neutrophil gelatin-associated lipocalin (NGAL), interleukin 18 (IL-18), and retinol-binding protein are emerging urinary biomarkers that have shown promise in detecting subclinical and clinical renal impairment. In this study, we assessed changes in these urinary biomarkers as well as serum creatinine (SCr) in patients undergoing EVAR. Urine samples were collected prospectively at 5 time points for each recruited patient: pre-EVAR (baseline) and 6, 12, 24, and 48 hours after the procedure for serial assessment of urinary biomarkers...
October 5, 2016: Angiology
Saranat Orrapin, Saritphat Orrapin, Supapong Arworn, Termpong Reanpang, Kittipan Rerkasem
We report two HIV infected patients with ruptured abdominal aneurysm by using endovascular aneurysm repair (EVAR) technique. A 59-year-old Thai man had a ruptured abdominal aortic aneurysm and a 57-year-old man had a ruptured iliac artery aneurysm. Both patients had a CD4 level below 200 μ/L indicating a low immune status at admission. They were treated by EVAR. Neither patient had any complications in 3 months postoperatively. EVAR may have a role in HIV patients with ruptured abdominal aneurysm together with very low immunity...
2016: Case Reports in Surgery
Gloria María Novo Martínez, Marta Ballesteros Pomar, Elena Menéndez Sánchez, Eliezer Santos Alcántara, Inés Rodríguez Fernández, Andrés Manuel Zorita Calvo
INTRODUCTION: Rupture of abdominal aortic aneurysm is still a difficult challenge for the vascular surgeon due to the high perioperative mortality. The aim of our study is to describe the characteristics of the population as well as to compare morbidity and mortality in patients undergoing open surgery or endovascular repair in our center. METHODS: Database with 82 rAAA between January 2002-December 2014, studying two cohorts, open surgery and endovascular repair...
October 1, 2016: Cirugía Española
Sotirios Giannakakis, George Galyfos, Georgios Geropapas, Stavros Kerasidis, Gerasimos Papacharalampous, Georgios Kastrisios, Chrisostomos Maltezos
A 75-year-old patient with severe comorbidities was treated with an Endurant(®) (Medtronic, USA) II endograft due to a ruptured abdominal aortic aneurysm (AAA). After four years of unremarkable follow-up, bilateral limb separation was detected. The patient underwent endovascular bridging without any complication. Although rarely detected in newer grafts, late bilateral type IIIa endoleaks can present and should be promptly repaired. Complex or ruptured AAAs treated with off-label use of endografts should be under closer surveillance using imaging tools for potential endoleaks or aneurysm sac growth...
September 2016: Vascular Specialist International
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
Juxtarenal aortic aneurysms (JRAAs) are challenging to treat by endovascular aneurysm repair (EVAR) procedures. The chimney technique with EVAR (Ch-EVAR) is one of the feasible and less invasive treatments for JRAAs. However, the main concern of Ch-EVAR is the potential risk of "gutters," which can lead to type Ia endoleak (EL). Most type Ia ELs after Ch-EVAR procedures occurred intraoperatively, and these ELs could be treated using an endovascular technique. However, late-onset type Ia ELs could be extremely rare, which might have a fear of conservative treatment...
2016: Case Reports in Vascular Medicine
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