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https://www.readbyqxmd.com/read/29147166/a-cost-utility-analysis-of-endovascular-aneurysm-repair-for-abdominal-aortic-aneurysm
#1
Yutaka Takayama
Objective: To assess medical economic adequacy of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Cost-utility analysis. A total of 21 patients with AAA treated at Ibaraki Prefectural Central Hospital in 2014 were divided into non-ruptured EVAR (Group E) and open surgery (OS) (Group O), and ruptured OS (Group R) groups, and hospital costs were aggregated with a medical accounting system. Mid-level hospital costs were estimated by a diagnosis-procedure-combination analysis system...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147158/successful-hybrid-treatment-of-stent-graft-migration-caused-by-type-b-aortic-dissection-after-endovascular-aortic-aneurysm-repair-a-case-report
#2
Tsunehiro Shintani, Kouji Atsuta, Takaaki Saito
Herein, we report a rare case of type B aortic dissection that occurred after endovascular aortic aneurysm repair (EVAR). A 66-year-old man underwent successful EVAR for an abdominal aortic aneurysm (AAA). Computed tomography (CT) 2 years after EVAR showed a type B aortic dissection with stent-graft migration and AAA expansion. Juxtarenal aortic expansion precluded simple stent-graft placement. He underwent hepato-spleno-renal bypass followed by stent-graft placement just below the superior mesenteric artery...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147153/successful-aortic-banding-for-type-ia-endoleak-due-to-neck-dilatation-after-endovascular-abdominal-aortic-aneurysm-repair-case-report
#3
Yasushi Tashima, Koichi Tamai, Takehiro Shirasugi, Kenichiro Sato, Takahiro Yamamoto, Yusuke Imamura, Atsushi Yamaguchi, Hideo Adachi, Toshiyuki Kobinata
A 69-year-old man with a type IA endoleak that developed approximately 21 months after endovascular abdominal aortic aneurysm repair (EVAR) of a 46 mm diameter aneurysm was referred to our department. He had impaired renal function, Parkinson's disease, and previous cerebral infarction. Computed tomography angiography showed a type IA endoleak with neck dilatation and that the aneurysm had grown to 60 mm in diameter. We decided to perform aortic banding. The type IA endoleak disappeared after banding and the patient was discharged on postoperative day 10...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29142494/endovascular-treatment-of-abdominal-aortic-aneurysm-with-complete-iliac-occlusion-case-series-and-literature-review
#4
Randall W Franz, M Taha Ibrahim, Christopher F Tanga, David A Epstein
In patients with abdominal aortic aneurysms (AAA) and complete iliac occlusion, endovascular aortic aneurysm repair (EVAR) using a bifurcated stent graft has clear advantages over aortouniiliac stent grafts. Bifurcated stent grafts had improved hemodynamic flow and increased primary and secondary patency rates compared with aortouniiliac stent grafts. The use of aortouniiliac stent grafts with femorofemoral crossover bypass is associated with complications including infection of the prosthesis, steal phenomenon, and the associated difficulties for further endovascular access at the site of the femoral anastomosis...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29122572/characterization-of-vessel-deformations-during-evar-a-preliminary-retrospective-analysis-to-improve-fidelity-of-endovascular-simulators
#5
Laura Cercenelli, Barbara Bortolani, Guido Tiberi, Chiara Mascoli, Ivan Corazza, Mauro Gargiulo, Emanuela Marcelli
OBJECTIVE: During endovascular aneurysm repair (EVAR), vessel deformations occur due to the insertion of tools and deployment of stent grafts in the arteries. We present a method for the characterization of vessel deformations during EVAR, and its application on patient datasets for a preliminary retrospective analysis that may be used to improve fidelity of endovascular simulators. DESIGN: The method provides the extraction of vessel profiles from intraoperative fluoroscopic images and the calculation of a tortuosity index in the 2D fluoroscopy view (τ2D) used to quantify the vessel deformations (δ%) during EVAR caused by the stiff guidewire insertion (δ%Stiff) and the stent graft deployment (δ%Graft), when compared with the undeformed vessel configuration (no device inserted)...
November 6, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#6
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29105814/late-onset-type-i-endoleak-characterized-by-contrast-enhanced-ultrasound-after-endovascular-repair-of-aortic-aneurysm
#7
John Nathan Gifford, Hsueh Wen Cheong, Wey Chyi Teoh
We report in the case of a patient with an intra-abdominal aortic aneurysm treated with endovascular aneurysm repair (EVAR) who developed renal impairment during the period of follow up. The repair was complicated with an early-onset type II endoleak which later evolved into a late-onset type I endoleak. It was treated with proximal extension of stent graft, with treatment success and follow-up documented on contrast enhanced ultrasound (CEUS). This case illustrates the usefulness of CEUS in post-EVAR surveillance and emphasizes the need for life-long monitoring as late-onset complications are not uncommon...
November 4, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#8
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29097346/preliminary-experience-with-the-use-of-ultra-low-profile-endografts
#9
Daniela Mazzaccaro, Giovanni Malacrida, Bruno Amato, Salvatore Alessio Angileri, Anna Maria Ierardi, Giovanni Nano
PURPOSE: We aimed to report a preliminary single-center experience of elective endovascular aortic repair (EVAR) using ultra-low profile (ULP) endografts of 14 F outer diameter. METHODS: Data of 67 consecutive patients who underwent EVAR using either Ovation (group A, n=30) or Incraft (group B, n=37) endografts were retrospectively analyzed. RESULTS: Aorto-iliac anatomy was significantly different between the two groups, as patients of group A had a greater thrombotic apposition on proximal aortic neck (thrombus thickness: 7...
November 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29097041/comparable-perioperative-mortality-outcomes-in-younger-patients-undergoing-elective-open-and-endovascular-abdominal-aortic-aneurysm-repair
#10
Nathan L Liang, Katherine M Reitz, Michel S Makaroun, Mahmoud B Malas, Edith Tzeng
BACKGROUND: Evidence for benefit of endovascular aneurysm repair (EVAR) over open surgical repair for de novo infrarenal abdominal aortic aneurysms (AAAs) in younger patients remains conflicting because of heterogeneous study populations and small sample sizes. The objective of this study was to compare perioperative and short-term outcomes for EVAR and open surgery in younger patients using a large national disease and procedure-specific data set. METHODS: We identified patients 65 years of age or younger undergoing first-time elective EVAR or open AAA repair from the Vascular Quality Initiative (2003-2014)...
October 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29079007/ten-year-outcome-analysis-of-the-italian-excluder-registry-with-the-gore-excluder-endograft-for-infrarenal-abdominal-aortic-aneurysms
#11
Giovanni Pratesi, Gabriele Piffaretti, Fabio Verzini, Giovanni De Blasis, Patrizio Castelli, Carlo Pratesi
OBJECTIVE: The objective of this study was to report the 10-year outcomes of the multicenter Italian Excluder Registry for elective endovascular aneurysm repair (EVAR). METHODS: A retrospective analysis of all patients who underwent elective EVAR using the Gore Excluder (W. L. Gore & Associates, Flagstaff, Ariz) endograft (EG) at four Italian centers between 1998 and 2006 was carried out. Follow-up consisted of duplex ultrasound scan and computed tomography performed at 1 month, 6 months, and 12 months and yearly thereafter...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29078248/-management-of-endograft-infection-after-evar-and-tevar-a-case-series-and-literature-review
#12
Thomas Betz, Ingolf Töpel, Markus Steinbauer, Christian Uhl
Introduction Endograft infection after EVAR (Endovascular aortic repair) or TEVAR (Thoracic endovascular aortic repair) is a rare but severe complication with high mortality. As the number of patients with endovascular aneurysm repair has increased over the last decade, the number of patients with endograft infection might also have increased. However, no guideline defines the treatment of endograft infection. Diagnosis is difficult and depends on clinical symptoms, radiological imaging and blood cultures. Surgery with graft excision, debridement and revascularisation should be proposed...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29074117/intensive-care-unit-admission-after-endovascular-aortic-aneurysm-repair-is-primarily-determined-by-hospital-factors-adds-significant-cost-and-is-often-unnecessary
#13
Caitlin W Hicks, Husain N Alshaikh, Devin Zarkowsky, Ian C Bostock, Besma Nejim, Mahmoud B Malas
BACKGROUND: A large proportion of endovascular aortic aneurysm repair (EVAR) patients are routinely admitted to the intensive care unit (ICU) for postoperative observation. In this study, we aimed to describe the factors associated with ICU admission after EVAR and to compare the outcomes and costs associated with ICU vs non-ICU observation. METHODS: All patients undergoing elective infrarenal EVAR in the Premier database (2009-2015) were included. Patients were stratified as ICU vs non-ICU admission according to location on postoperative day 0...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074115/characterization-and-outcomes-of-reinterventions-in-food-and-drug-administration-approved-versus-trial-endovascular-aneurysm-repair-devices
#14
Alexander S Fairman, Grace J Wang, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Venkat Kalapatapu, Michael A Golden, Ronald M Fairman
OBJECTIVE: Published rates of reintervention after endovascular aneurysm repair (EVAR) range from 10% to 30%. We evaluated a single university center's experience with reinterventions in the context of Food and Drug Administration (FDA)-approved and trial devices. METHODS: Retrospective data collection was performed for patients who underwent infrarenal EVAR and required reintervention from 2000 to 2016. Trial devices included those used in FDA feasibility and pivotal trials...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074111/polar-orientation-of-renal-grafts-within-the-proximal-seal-zone-affects-risk-of-early-type-ia-endoleaks-after-chimney-endovascular-aneurysm-repair
#15
Kenneth Tran, Brant W Ullery, Nathan Itoga, Jason T Lee
OBJECTIVE: The objective of this study was to describe the polar orientation of renal chimney grafts within the proximal seal zone and to determine whether graft orientation is associated with early type Ia endoleak or renal graft compression after chimney endovascular aneurysm repair (ch-EVAR). METHODS: Patients who underwent ch-EVAR with at least one renal chimney graft from 2009 to 2015 were included in this analysis. Centerline three-dimensional reconstructions were used to analyze postoperative computed tomography scans...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074109/racial-disparities-in-outcomes-after-intact-abdominal-aortic-aneurysm-repair
#16
Sarah E Deery, Thomas F X O'Donnell, Katie E Shean, Jeremy D Darling, Peter A Soden, Kakra Hughes, Grace J Wang, Marc L Schermerhorn
OBJECTIVE: We aimed to compare perioperative morbidity and mortality and late survival among black, white, and Asian patients undergoing intact abdominal aortic aneurysm (AAA) repair. METHODS: We identified all patients undergoing intact, infrarenal AAA repair in the Vascular Quality Initiative (VQI) from 2003 to 2017. We compared in-hospital outcomes by race using the Fisher exact and Kruskal-Wallis tests. Multivariable logistic and linear regression models of perioperative outcomes adjusted for differences in demographics, comorbidities, hospital volume, and procedure...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29066242/estimating-risk-of-adverse-cardiac-event-after-vascular-surgery-using-currently-available-online-calculators
#17
Danielle A Moses, Lily E Johnston, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
BACKGROUND: The decision to proceed with vascular surgical interventions requires evaluation of cardiac risk. Recently, several online risk calculators were created to predict outcomes and to lead to a more informed conversation between surgeons and patients. The objective of this study was to compare and further validate these online calculators with actual adverse cardiac outcomes at a single institution. METHODS: All patients from January 2011 through December 2015 undergoing carotid endarterectomy (CEA), infrainguinal lower extremity bypass, open abdominal aortic aneurysm (AAA) repair, and endovascular aneurysm repair (EVAR) on the vascular surgical service were included using the Society for Vascular Surgery Vascular Quality Initiative database at our health system...
October 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29064769/gender-differences-in-abdominal-aortic-aneurysms-in-germany-using-health-insurance-claims-data
#18
Konstanze Stoberock, Henrik Christian Rieß, Eike Sebastian Debus, Thea Schwaneberg, Tilo Kölbel, Christian-Alexander Behrendt
BACKGROUND: Endovascular aortic repair (EVAR) has emerged as standard of care for abdominal aortic aneurysm (AAA). Real-world evidence is limited to compare this technology to open repair (OAR). Major gaps exist related to short-term and long-term outcomes, particularly in respect of gender differences. MATERIALS AND METHODS: Health insurance claims data from Germany's third largest insurance provider, DAK-Gesundheit, was used to investigate invasive in-hospital treatment of intact (iAAA) and ruptured AAA (rAAA)...
October 24, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29061269/comparison-of-percutaneous-versus-open-femoral-cutdown-access-for-endovascular-repair-of-ruptured-abdominal-aortic-aneurysms
#19
COMPARATIVE STUDY
Samuel L Chen, Nii-Kabu Kabutey, Matthew D Whealon, Isabella J Kuo, Roy M Fujitani
OBJECTIVE: Ruptured endovascular aortic aneurysm repair (REVAR) is being increasingly used to treat ruptured abdominal aortic aneurysms (rAAAs). However, the comparison between totally percutaneous (pREVAR) vs femoral cutdown (cREVAR) access for REVAR has not been studied. We used a national surgical database to evaluate the 30-day outcomes in patients undergoing pREVAR vs cREVAR. METHODS: Patients who underwent EVAR for rAAA between 2011 and 2014, inclusively, were studied in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular database...
November 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29054934/radiation-induced-dna-damage-in-operators-performing-endovascular-aortic-repair
#20
Tamer El-Sayed, Ashish S Patel, Jun S Cho, James A Kelly, Francesca E Ludwinski, Prakash Saha, Oliver T Lyons, Alberto Smith, Bijan Modarai
Background -Radiation exposure during fluoroscopically-guided interventions such as endovascular aortic repair (EVAR) is a growing concern for operators. This study aimed to measure DNA damage/repair markers in operators perfoming EVAR. Methods -Expression of the DNA damage/repair marker, gamma-H2AX (γ-H2AX) and DNA damage response (DDR) marker, phosphorylated ataxia telangiectasia mutated (pATM), were quantified in circulating lymphocytes in operators during the peri-operative period of endovascular (infra-renal [IEVAR], branched [BEVAR] and fenestrated [FEVAR]) and open aortic repair using flow cytometry...
October 20, 2017: Circulation
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