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https://www.readbyqxmd.com/read/29784569/use-of-the-zenith-fenestrated-platform-to-rescue-failing-endovascular-and-open-aortic-reconstructions-is-safe-and-technically-feasible
#1
S Keisin Wang, Natalie A Drucker, Alan P Sawchuk, Gary W Lemmon, Michael C Dalsing, Raghu L Motaganahalli, Michael P Murphy, Andres Fajardo
OBJECTIVE: Proximal neck dilation is a serious long-term complication directly causing the failure of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms. However, the implantation of a fenestrated device presents the opportunity for proximal extension of the aortic reconstruction into a healthy segment while maintaining patency of the visceral vessels. The objective of this investigation was to report perioperative and follow-up outcomes using the Zenith Fenestrated (ZFEN; Cook Medical, Bloomington, Ind) aortic stent system in salvaging previous aortic repairs undergoing type IA endoleak or aneurysmal degeneration of the proximal neck...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29784568/assessment-of-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-using-the-national-surgical-quality-improvement-program-procedure-targeted-data-set
#2
Hanaa Dakour-Aridi, Nawar Z Paracha, Satinderjit Locham, Besma Nejim, Mahmoud B Malas
OBJECTIVE: Open aortic repair (OAR) is associated with higher risk of mortality compared with endovascular aneurysm repair (EVAR). The aim of this study was to compare failure to rescue (FTR) after major predischarge complications in patients undergoing OAR and EVAR. METHODS: Patients who underwent OAR or EVAR in the American College of Surgeons National Surgical Quality Improvement Program between 2011 and 2015 were selected. Patients with ruptured aneurysm and those with type IV thoracoabdominal aneurysms were excluded...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29780894/multiple-re-entry-closures-after-tevar-for-ruptured-chronic-post-dissection-thoraco-abdominal-aortic-aneurysm
#3
R Kinoshita, F Ganaha, J Ito, N Ohyama, N Abe, T Yamazato, H Munakata, K Mabuni, T Kugai
Introduction: Although thoracic endovascular aortic repair (TEVAR) has become a promising treatment for complicated acute type B dissection, its role in treating chronic post-dissection thoraco-abdominal aortic aneurysm (TAA) is still limited owing to persistent retrograde flow into the false lumen (FL) through abdominal or iliac re-entry tears. Report: A case of chronic post-dissection TAA treatment, in which a dilated descending FL ruptured into the left thorax, is described...
2018: EJVES Short Reports
https://www.readbyqxmd.com/read/29780288/the-assessment-of-carbon-dioxide-automated-angiography-in-type-ii-endoleaks-detection-comparison-with-contrast-enhanced-ultrasound
#4
Chiara Mascoli, Gianluca Faggioli, Enrico Gallitto, Vincenzo Vento, Giuseppe Indelicato, Rodolfo Pini, Andrea Vacirca, Andrea Stella, Mauro Gargiulo
Introduction: Iodinated contrast media completion angiography (ICM-A) may underestimate the presence of type II endoleak (ELII) after endovascular aortic repair (EVAR), particularly if they are at low flow. Contrast-enhanced ultrasound (CEUS) has been proposed as the gold standard in ELII detection during EVAR follow-up. Intraprocedural carbon dioxide (CO2 ) angiography has been shown to be useful in this setting; however no comparative studies including these three techniques are currently available...
2018: Contrast Media & Molecular Imaging
https://www.readbyqxmd.com/read/29779291/abdominal-aortic-aneurysm-an-update
#5
Jason Chuen, Mayo Theivendran
BACKGROUND: Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Treatment options have expanded in recent years to increase the range of morphology suitable for endovascular aneurysm repair (EVAR), and with potential implications on treatment thresholds. OBJECTIVE: This article is the first of two that will outline current treatment options for AAA, including areas of controversy and research in AAA disease, to inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779153/intraoperative-stent-segmentation-in-x-ray-fluoroscopy-for-endovascular-aortic-repair
#6
Katharina Breininger, Shadi Albarqouni, Tanja Kurzendorfer, Marcus Pfister, Markus Kowarschik, Andreas Maier
PURPOSE: Fusion of preoperative data with intraoperative X-ray images has proven the potential to reduce radiation exposure and contrast agent, especially for complex endovascular aortic repair (EVAR). Due to patient movement and introduced devices that deform the vasculature, the fusion can become inaccurate. This is usually detected by comparing the preoperative information with the contrasted vessel. To avoid repeated use of iodine, comparison with an implanted stent can be used to adjust the fusion...
May 19, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29778615/explanting-the-nellix-endovascular-aortic-sealing-endoprosthesis-for-proximal-aortic-neck-failure
#7
Cheong Jun Lee, Robert Cuff
Open conversion following endovascular aortic repair (EVAR) has inherent challenges particular to the device being explanted. The Nellix endograft is unlike any other device as it utilizes polymer filling of endobags within the aorto-iliac lumen to seal the AAA sac; a developing concept known as endovascular aortic sealing (EVAS). Conversion to open repair of AAA treated with the Nellix endograft have rarely been discussed. Explants that have been previously reported were for graft infection. We present two Nellix graft explants that were required for device migration and subsequent development of a type IA endoleak...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778613/evar-first-strategy-for-ruptured-aneurysm-focuses-on-fitzgerald-classification-and-vein-thrombosis
#8
Yuri Murakami, Naoki Toya, Soichiro Fukushima, Eisaku Ito, Tadashi Akiba, Takao Ohki
BACKGROUND: We report on the results of our endovascular aneurysm repair (EVAR)-first strategy for ruptured abdominal aortic aneurysms (RAAAs) focuses on Fitzgerald classification and vein thrombosis. MATERIALS AND METHODS: From 2011 to 2017, 31 patients with RAAA underwent EVAR at our hospital. We compared Fitzgerald (F)-1 patients (group A) with F-2-4 patients with obvious retroperitoneal hematoma (group B). RESULTS: The baseline characteristics in group A (n=9) and group B (n=22) were similar...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778608/technical-success-and-long-term-results-with-excluder-c3-endoprosthesis-in-narrow-aortic-biforcations-first-italian-multicentre-experience
#9
Gian Franco Veraldi, Luca Mezzetto, Filippo Vaccher, Lorenzo Scorsone, Stefano Bonvini, Igor Raunig, Valentina Wassermann, Sebastiano Tasselli
PURPOSE: This study aims at evaluating technical success and long-term results using Gore Excluder/C3 endoprosthesis in patients with narrow aortic bifurcation (NAB, inner-inner aortic diameter <18mm). METHODS: Clinical and anatomical data were collected retrospectively from patients treated in two high-volume Italian vascular centres between 2005 and 2017. A total of 1325 EVAR procedures were performed: 195 involved Excluder/C3 Gore endoprosthesis. 141 patients had a regular aortic bifurcation (RAB, maximum inner-inner diameter ≥ 18mm), while 54 presented NAB (< 18mm)...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772328/current-evidence-on-management-of-aortic-stent-graft-infection-a-systematic-review-and-meta-analysis
#10
REVIEW
Hai Lei Li, Yiu Che Chan, Stephen W Cheng
OBJECTIVE: Aortic stent-graft infection is rare, but remains one of the most challenging and threatening complications. This systematic review aimed to identify the clinical features, treatment and outcomes of endograft infection after abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). METHODS: A systematic literature review of all published literature from January 1991 to September 2016 on stent-graft infection was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772324/morphology-related-limitations-of-evar-applicability-in-the-treatment-of-aaa-in-west-central-poland
#11
Łukasz Dzieciuchowicz, Jolanta Tomczak, Ewa Strauss, Grzegorz Oszkinis
BACKGROUND: To analyze the current applicability of endovascular aneurysm repair (EVAR) in patients with an infrarenal abdominal aortic aneurysm (AAAs) with indication for elective treatment in West-Central Poland. METHODS: Computed tomography angiograms of 100 consecutive patients with infrarenal AAA deemed to require treatment were analyzed with an OsiriX DICOM viewer in 3D-MPR mode. Proximal neck diameter, length, angulation, shape, the presence of thrombus and calcification, distal neck diameter, and morphology of the iliac arteries were determined...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772314/urgent-use-of-gore-excluder-iliac-branch-endoprosthesis-ibe-with-left-transaxillary-approach-for-preservation-of-the-residual-hypogastric-artery-a-case-series
#12
D'Oria Mario, Chiarandini Stefano, Pipitone Marco, Calvagna Cristiano, Riccitelli Francesco, Rotelli Alice, Zamolo Francesca, Griselli Filippo
Preservation of the residual hypogastric artery (HGA) in patients with previous endovascular aortic aneurysm repair (EVAR) may require complex operative strategies. We report an alternative technique to preserve the residual HGA with the Gore Excluder Iliac Branch endoprosthesis (IBE) in urgent situations. MethodsWe report the case of two high-risk patients (unfit for open surgery), with previous EVAR and exclusion of one HGA, treated in emergency setting. Both patients met the anatomical requirements for Gore IBE use...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772312/early-and-late-outcomes-of-endovascular-aortic-aneurysm-repair-versus-open-surgical-repair-of-an-abdominal-aortic-aneurysm-a-single-center-study
#13
Kyunghak Choi, Youngjin Han, Gi-Young Ko, Yong-Pil Cho, Tae-Won Kwon
OBJECTIVE: To compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center. METHODS: Patients treated for an AAA at a single center between January 2007 and December 2012 were retrospectively identified and classified based on the treatment that they received (EVAR or OSR). Patient demographics, and in hospital costs were recorded. Long-term survival was calculated using the Kaplan-Meier method...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772311/mid-term-outcomes-of-endovascular-aortic-aneurysm-repair-with-carbon-dioxide-guided-angiography
#14
Yuriko Takeuchi, Noriyasu Morikage, Yutaro Matsuno, Tamami Nakamura, Makoto Samura, Koshiro Ueda, Takasuke Harada, Yoshitaka Ikeda, Kotaro Suehiro, Hiroshi Ito, Kensuke Sakata, Kimikazu Hamano
BACKGROUND: Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO2 -guided angiography. METHODS: Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO2 -EVAR group (n=30)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770795/cytokines-as-biomarkers-of-inflammatory-response-after-open-versus-endovascular-repair-of-abdominal-aortic-aneurysms-a-systematic-review
#15
REVIEW
Diamantis I Tsilimigras, Fragiska Sigala, Georgios Karaolanis, Ioannis Ntanasis-Stathopoulos, Eleftherios Spartalis, Michael Spartalis, Nikolaos Patelis, Alexandros Papalampros, Chandler Long, Demetrios Moris
The repair of an abdominal aortic aneurysm (AAA) is a high-risk surgical procedure related to hormonal and metabolic stress-related response with an ensuing activation of the inflammatory cascade. In contrast to open repair (OR), endovascular aortic aneurysm repair (EVAR) seems to decrease the postoperative stress by offering less extensive incisions, dissection, and tissue manipulation. However, these beneficial effects may be offset by the release of cytokines and arachidonic acid metabolites during intra-luminal manipulation of the thrombus using catheters in endovascular repair, resulting in systemic inflammatory response (SIR), which is clinically called post-implantation syndrome...
May 17, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29764709/influence-of-proximal-aortic-neck-diameter-on-durability-of-aneurysm-sealing-and-overall-survival-in-patients-undergoing-endovascular-aneurysm-repair-real-world-data-from-the-gore-global-registry-for-endovascular-aortic-treatment-great
#16
Dominic P J Howard, Conor D Marron, Ediri Sideso, Phillip J Puckridge, Eric L G Verhoeven, James I Spark
OBJECTIVES: Aortic neck diameter is an independent anatomical feature that is poorly understood, yet potentially linked to proximal seal failure and adverse outcome following standard EVAR. The aim of this study was to assess whether large proximal aortic neck (LAN) diameter is associated with adverse outcome using prospectively collected individual patient data from The Global Registry for Endovascular Aortic Treatment (GREAT). METHODS: A total of 3166 consecutive patients, from 78 global centres, receiving Gore Excluder stent grafts for infrarenal abdominal aortic aneurysm repair between 2011 and 2017 were included...
May 12, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29754017/reparaci%C3%A3-n-endovascular-para-aneurisma-de-aorta-revisi%C3%A3-n-panor%C3%A3-mica-sobre-su-evidencia-en-el-mundo-y-su-aplicaci%C3%A3-n-en-latinoam%C3%A3-rica
#17
María Calderón, Viviana Brito, Andrea Alcaraz, Lucila Rey-Ares, Federico Augustovski, Sebastián García-Martí, Ariel Bardach, Agustín Ciapponi, Analía López, Andrés Pichón-Riviere
BACKGROUND: Aortic aneurysm (AA) is a pathology with high morbidity and mortality. The management can be expectant, surgical, or through endovascular repair (EVAR). In Latin America the incidence of AA has increased and the analysis of therapeutic options, especially if they are expensive, is fundamental. OBJECTIVE: To analyze available evidence on the effectiveness, safety and coverage policies of the EVAR. METHODOLOGY: Panoramic review in the main bibliographical bases (MEDLINE, LILACS, EMBASE, Cochrane Library, DARE) and generic internet searchers, main health technology assessment (HTA) agencies and health insurance companies...
May 10, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29752606/a-methodology-for-in-silico-endovascular-repair-of-abdominal-aortic-aneurysms
#18
André Hemmler, Brigitta Lutz, Christian Reeps, Günay Kalender, Michael W Gee
Endovascular aneurysm repair (EVAR) can involve some unfavorable complications such as endoleaks or stent-graft (SG) migration. Such complications, resulting from the complex mechanical interaction of vascular tissue, SG and blood flow or incompatibility of SG design and vessel geometry, are difficult to predict. Computational vascular mechanics models can be a predictive tool for the selection, sizing and placement process of SGs depending on the patient-specific vessel geometry and hence reduce the risk of potential complications after EVAR...
May 11, 2018: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29745763/influences-of-clinical-experience-in-the-quantification-of-morphometric-sarcopaenia-a-cohort-study
#19
Mohammed A Waduud, Michael Drozd, Emma Linton, Benjamin Wood, James Manning, Marc A Bailey, Christopher Hammond, Julian A Scott
OBJECTIVE: The measurement of total psoas muscle area (TPMA) on Computed Tomography (CT) imaging is commonly made using either manual tracing or a semi-automated technique. We examined whether clinical experience influenced measurement of TPMA when utilising these two commonly used methods and describe the relationship between techniques. METHODS: Pre-operative cross-sectional CT imaging of 114 consecutive patients undergoing elective EVAR were analysed. Retrospective measurements of the TPMA were performed by four independent investigators with a range of clinical experience (medical student to specialist surgical registrar) using either technique...
May 10, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29745617/predictors-of-long-term-mortality-following-elective-endovascular-repair-of-abdominal-aortic-aneurysms
#20
Guilherme Marques-Rios, José Oliveira-Pinto, Armando Mansilha
INTRODUCTION: Endovascular aneurysm repair (EVAR) became the preferred modality for abdominal aortic aneurysm (AAA) repair. However, long term survival benefit may sometimes be questionable as many patients would die from other causes rather than aneurysm rupture. It is paramount to identify critical risk factors for late mortality after EVAR to understand its real benefit. The aim of this review is to identify most clinically relevant determinants of late mortality after elective EVAR...
May 9, 2018: International Angiology: a Journal of the International Union of Angiology
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