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https://www.readbyqxmd.com/read/28648757/prolonged-icu-length-of-stay-after-aaa-repair-analysis-of-time-trends-and-long-term-outcome
#1
H Gavali, K Mani, G Tegler, R Kawati, L Covaciu, A Wanhainen
OBJECTIVE: The aim of the study was to investigate the frequency and outcome of prolonged intensive care unit (ICU) length of stay (LOS) after abdominal aortic aneurysm (AAA) repair in the endovascular era. METHODS: All patients operated on for AAA between 1999 and 2013 at Uppsala University hospital were identified. Data were retrieved from the Swedish Vascular registry, the Swedish Intensive Care registry, the National Population registry, and case records. Prolonged ICU LOS was defined as ≥ 48 h during the primary hospital stay...
June 22, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#2
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647340/a-simulator-for-training-in-endovascular-aneurysm-repair-the-use-of-three-dimensional-printers
#3
I O Torres, N De Luccia
OBJECTIVES: To develop an endovascular aneurysm repair (EVAR) simulation system using three dimensional (3D) printed aneurysms, and to evaluate the impact of patient specific training prior to EVAR on the surgical performance of vascular surgery residents in a university hospital in Brazil. METHODS: This was a prospective, controlled, single centre study. During 2015, the aneurysms of patients undergoing elective EVAR at São Paulo University Medical School were 3D printed and used in training sessions with vascular surgery residents...
June 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#4
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28639918/midterm-analysis-of-survival-and-cause-of-death-following-endovascular-abdominal-aortic-aneurysm-repair
#5
Gerard M Healy, Ciaran E Redmond, Sam Gray, Lucian Iacob, Stephen Sheehan, Joseph F Dowdall, Mary Barry, Colin P Cantwell, David P Brophy
PURPOSE: To assess rates of complications, secondary interventions, survival, and cause of death following endovascular abdominal aortic aneurysm (AAA) repair over a 10-year period. MATERIALS AND METHODS: Single-institution retrospective cohort study of all patients undergoing primary endovascular aortic aneurysm repair (EVAR) between July 2006 and June 2015. The population constituted 175 patients with 163 fusiform and 12 saccular AAAs. Of these, 149 (85%) were male, with mean age 75...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28638973/a-retrospective-observational-cohort-study-investigating-the-association-between-acute-kidney-injury-and-all-cause-mortality-among-patients-undergoing-endovascular-repair-of-abdominal-aortic-aneurysms
#6
Kimito Minami, Yoko Sugiyama, Hiroki Iida
BACKGROUND: Acute kidney injury (AKI) has been found to be associated with short- and long-term mortality and morbidity in various clinical settings. However, it is unknown whether AKI after endovascular repair of abdominal aortic aneurysms (EVAR) is associated with postoperative mortality. METHODS: This observational study analyzed patients who underwent EVAR. The primary outcome was all-cause mortality. The outcomes of patients with and without postoperative AKI were compared using the Kaplan-Meier method and log-rank test...
June 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28634567/aaa-rupture-and-psoas-hematoma-due-to-type-ii-endoleak-from-inferior-mesenteric-artery-unusual-collaterals
#7
Panagiotis G Theodoridis, Dimitrios N Staramos, Nikolaos Ptochis, Ioannis A Papailiou, Ilias Dodos, Nikolaos Iatrou, Anastasios G Potouridis, Konstantinos Dervisis
Although endovascular aneurysm repair (EVAR) in the abdominal aorta has reduced the perioperative mortality when compared with open repair, the need for reintervention after complications such as endoleak may be presented in up to 20% of the cases. Type II endoleak from branch vessels is often benign but can potentially be associated with progressive abdominal aortic aneurysm growth and sac expansion. We present a rare case of a patient who presented with sac expansion and psoas hematoma due to Type II endoleak from "unusual" collaterals of IMA and was treated successfully with endoleak microembolization and percutaneous decompression of the hematoma...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28633519/changes-in-abdominal-aortic-aneurysm-epidemiology
#8
Fredrik Lilja, Anders Wanhainen, Kevin Mani
INTRODUCTION: The epidemiology and treatment of abdominal aortic aneurysms (AAA) has changed over the past 30 years. EVIDENCE ACQUISITION: This review aims to give the reader an overview of these changes and current trends in AAA epidemiology, management and outcome. EVIDENCE SYNTHESIS: In the past decades there have been three changes in AAA management and epidemiology: a) introduction of endovascular aortic repair (EVAR), b) population screening and c) a markedly reduced prevalence of the disease...
June 20, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28627864/type-ii-endoleaks-when-and-how
#9
Matthew J Grima, Alan Karthikesalingam
Although most type II endoleaks are self-limiting, the most common indication for secondary intervention after endovascular aneurysm repair (EVAR) is type II endoleak. However, it is still debatable when to treat them. Furthermore, different intervention techniques are available to treat type II endoleaks. The aim of this review is to look at current evidence and updates on type II endoleaks after EVAR for abdominal aortic aneurysm and their management.
June 19, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28627863/endovascular-treatment-of-mycotic-aortic-aneurysms-a-paradigm-shift
#10
Karl Sörelius, Kevin Mani, Martin Björck, Anders Wanhainen
Treatment of mycotic aortic aneurysms (MAA) composes a particularly difficult challenge. Open repair (OR) has been considered the gold standard, despite lack of evidence supporting its superiority compared with the emerging alternative endovascular aortic repair (EVAR). This review discusses the pros and cons of EVAR for MAAs by dissecting the three largest publications on MAAs, and concludes that there has been a paradigm shift in treatment of MAAs for the benefit of EVAR.
June 19, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28608956/systematic-review-of-mortality-risk-prediction-models-in-the-era-of-endovascular-abdominal-aortic-aneurysm-surgery
#11
REVIEW
N Lijftogt, T W F Luijnenburg, A C Vahl, E D Wilschut, V J Leijdekkers, M F Fiocco, M W J M Wouters, J F Hamming
BACKGROUND: The introduction of endovascular aneurysm repair (EVAR) has reduced perioperative mortality after abdominal aortic aneurysm (AAA) surgery. The objective of this systematic review was to assess existing mortality risk prediction models, and identify which are most useful for patients undergoing AAA repair by either EVAR or open surgical repair. METHODS: A systematic search of the literature was conducted for perioperative mortality risk prediction models for patients with AAA published since 2006...
July 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28604376/aortic-surgery-and-laparoscopy-still-a-future-in-the-endovascular-surgery-era
#12
Pierfrancesco Veroux, Vincenzo Ardita, Alessia Giaquinta, Alberto Davì, Giusi Basile, Massimiliano Veroux
Laparoscopic surgery (LS) is the minimally invasive alternative to open surgery and endovascular approach for treating major aortic diseases. Only few reports in the literature describe the long-term outcomes of the laparoscopic approach for major vascular diseases. Furthermore, the widespread use of endovascular techniques has limited the use of LS to wellselected patients. This review evaluated the results of LS for aortic disease and compared the clinical outcomes of laparoscopic technique with those of open and endovascular surgery...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28602897/lower-extremity-ischemia-after-abdominal-aortic-aneurysm-repair
#13
C A Behrendt, A Dayama, E S Debus, F Heidemann, N M Matolo, T Kölbel, N Tsilimparis
OBJECTIVE: Treatment reality of abdominal aortic aneurysm (AAA) is changing. Up to date, approximately 65% of intact AAA and 30% of ruptured AAA are treated endovascularly. As most comparative studies focus upon mortality and few major complications, some outcomes as lower extremity ischemia (LEI) after invasive AAA repair are often underreported. However, there is evidence for a worse outcome of patients suffering from this kind of complication. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) vascular surgery targeted module from 2011 to 2014, we identified all patients undergoing endovascular aortic repair (EVAR) and open aortic repair (OAR) for AAA to illuminate the incidence and outcome of LEI after AAA repair...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28602578/femoral-arterial-haemostasis-using-an-anchored-collagen-plug-after-percutaneous-evar-with-an-ultra-low-profile-device-prospective-audit-of-an-evolving-post-close-technique
#14
A Chaudhuri
OBJECTIVE: To present an audit of a successful "post-close" haemostatic technique using the Angio-Seal VIP vascular closure device (VCD) after percutaneous endovascular aneurysm repair (p-EVAR) using an ultra-low profile (ULP) device. METHODS: Thirty patients underwent EVAR using the Ovation device, of which 26 procedures were totally percutaneous. Data including patient habitus, procedural details, number of VCDs deployed including use of the double wire approach, and technical success/complications were prospectively recorded...
June 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28598495/ultrasonography-for-endoleak-detection-after-endoluminal-abdominal-aortic-aneurysm-repair
#15
REVIEW
Iosief Abraha, Maria Laura Luchetta, Rita De Florio, Francesco Cozzolino, Giovanni Casazza, Piergiorgio Duca, Basso Parente, Massimiliano Orso, Antonella Germani, Paolo Eusebi, Alessandro Montedori
BACKGROUND: People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. OBJECTIVES: To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS) in terms of sensitivity and specificity for endoleak detection after endoluminal abdominal aortic aneurysm repair (EVAR)...
June 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28596928/pulmonary-embolism-due-to-inferior-vena-cava-compression-by-a-retroperitoneal-hematoma-after-endovascular-repair-of-a-ruptured-abdominal-aortic-aneurysm
#16
Kota Shukuzawa, Naoki Toya, Yasutake Momokawa, Soichiro Fukushima, Tadashi Akiba, Takao Ohki
We report a case of a patient with a residual hematoma compressing the inferior vena cava after endovascular aneurysm repair (EVAR), which led to a pulmonary embolism (PE). A 65-year-old man underwent emergent EVAR for a ruptured aortic aneurysm in the right retroperitoneal region. He developed sudden chest pain at midnight of the fifth day after EVAR, and computed tomography demonstrated a massive PE. He subsequently went into cardiopulmonary arrest. This case suggested that abdominal complications due to a residual hematoma, including deep vein thrombosis and PE, should be considered in addition to compartment syndrome...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28592215/toward-an-evar-prevention-strategy-for-type-ii-endoleak
#17
George N Kouvelos, Miltiadis Matsagkas, Konstantinos Spanos, Athanasios Giannoukas
No abstract text is available yet for this article.
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28583728/conical-neck-is-strongly-associated-with-proximal-failure-in-standard-endovascular-aneurysm-repair
#18
Georgios A Pitoulias, Andrés Reyes Valdivia, Suteekhanit Hahtapornsawan, Giovanni Torsello, Apostolos G Pitoulias, Martin Austermann, Claudio Gandarias, Konstantinos P Donas
OBJECTIVE: Hostile proximal aortic neck (HN) challenges the suitability for standard endovascular aneurysm repair (EVAR) of patients at high risk for "open" repair. However, there has been little if any focus placed on the individual role of the "nonlength" HN features in EVAR outcomes. The aim of this study was to evaluate their individual and potentially predictive role in outcomes of EVAR under HN conditions. METHODS: Data of 156 consecutive EVAR patients with short (<15 mm) HN, treated with the Endurant device (Medtronic Cardiovascular, Santa Rosa, Calif) at three European academic vascular centers between 2007 and 2015, were collected and retrospectively analyzed...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28580349/ultrasound-fusion-imaging-with-real-time-navigation-for-the-surveillance-after-endovascular-aortic-aneurysm-repair
#19
Jin Hyun Joh, Sang-Ah Han, Sang-Hyun Kim, Ho-Chul Park
Ultrasound can be an effective alternative to computed tomography for surveillance following endovascular aneurysm repair (EVAR). Recently, ultrasound fusion imaging with the real-time navigation system was introduced. Here we described 3 patients who underwent post-EVAR surveillance using this novel technique. Complete coregistration was achieved in all patients. The origin of left renal artery was selected for the target of coregistration. Ultrasound fusion imaging was useful to differentiate the confusing lesion and to evaluate the complete resolution of endoleak and newly developed delayed endoleak...
June 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28579278/higher-30-day-mortality-in-patients-with-familial-abdominal-aortic-aneurysm-after-evar
#20
K M van de Luijtgaarden, F Bastos Gonçalves, S E Hoeks, J D Blankensteijn, D Böckler, R J Stolker, H J M Verhagen
OBJECTIVES: To determine the influence of a positive family history for aneurysms on clinical success and mortality after endovascular aneurysm repair (EVAR). METHODS: From 2009 to 2011, 1262 patients with abdominal aortic aneurysms (AAA) treated by EVAR were enrolled in a prospective, industry sponsored clinical registry ENGAGE. Patients were classified into familial and sporadic AAA patients according to baseline clinical reports. Clinical characteristics, aneurysm morphology, and follow-up were registered...
June 1, 2017: European Journal of Vascular and Endovascular Surgery
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