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Type 2 endoleak

Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
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
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
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
Benjamin W Starnes, Rachel E Heneghan, Billi Tatum
OBJECTIVE: The objective of this study was to report midterm results of an ongoing physician-sponsored investigational device exemption pivotal clinical trial using physician-modified endovascular grafts (PMEGs) for treatment of patients with juxtarenal aortic aneurysms who are deemed unfit for open repair. METHODS: Data from a nonrandomized, prospective, consecutively enrolling investigational device exemption clinical trial were used. Data collection began on April 1, 2011, and data lock occurred on May 31, 2015, with outcomes analysis through December 31, 2015...
September 26, 2016: Journal of Vascular Surgery
H W Wu, L Sun, D M Li, H Jing, B Xu, C T Wang, L Zhang
Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Suvi Väärämäki, Velipekka Suominen, Georg Pimenoff, Jukka Saarinen, Ilkka Uurto, Juha Salenius
OBJECTIVE: To report our long-term experience in using the hybrid technique in complex thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between March 2005 and September 2013, 10 patients with TAAA underwent hybrid procedures with open renovisceral revascularization and thoracoabdominal aortic endografting. Patients were analyzed retrospectively. RESULTS: Six men and 4 women with a mean age of 66 years (range 54-81 years) were treated electively during the study period...
October 2016: Vascular and Endovascular Surgery
G N Kouvelos, A Katsargyris, G A Antoniou, K Oikonomou, E L G Verhoeven
AIM: The aim was to conduct a systematic review of the literature investigating outcomes after interruption or preservation of the internal iliac artery (IIA) during endovascular aneurysm repair (EVAR). METHODS: A systematic review was undertaken using the MEDLINE and EMBASE databases to identify studies reporting IIA management during EVAR. The search identified 57 articles: 30 reported on IIA interruption (1468 patients) and 27 on IIA preservation (816 patients)...
September 2, 2016: European Journal of Vascular and Endovascular Surgery
Richard Nolz, Ulrika Asenbaum, Julia Furtner, Ramona Woitek, Sylvia Unterhumer, Andreas Wibmer, Alexander Prusa, Christian Loewe, Maria Schoder
[This corrects the article DOI: 10.1371/journal.pone.0149725.].
2016: PloS One
Toshiya Nishibe, Toru Iwahashi, Kentaro Kamiya, Kayo Toguchi, Keita Maruno, Toshiki Fujiyoshi, Yukio Muromachi, Shun Suzuki, Jun Koizumi, Hitoshi Ogino
BACKGROUND: We aimed to review 50 consecutive Japanese abdominal aortic aneurysm (AAA) and common iliac aneurysm (CIAA) patients to evaluate the 2-year outcomes, particularly endoleak and aneurysm sac shrinkage, of the Endurant stent graft. METHODS: Between June 2012 and January 2014, 50 consecutive Japanese AAA and CIAA patients underwent EVAR with the Endurant stent graft. Clinical outcomes of overall survival, aneurysm-related survival, and secondary intervention-free survival were analyzed; endoleaks and aneurysm sac changes were also evaluated...
August 30, 2016: International Angiology: a Journal of the International Union of Angiology
Drosos Kotelis, Karina Schleimer, Houman Jalaie, Jochen Grommes, Michael J Jacobs, Johannes Kalder
PURPOSE: To report operative and midterm outcomes of fenestrated endovascular aneurysm repair (FEVAR) with the Anaconda device. METHODS: A retrospective analysis was conducted of 39 consecutive patients (median age 74 years; 36 men) treated with the fenestrated Anaconda stent-graft between July 2011 and December 2015 at a single center. Indications for FEVAR were abdominal aortic aneurysms (AAAs) with neck anatomy unsuitable for a standard stent-graft. Median infrarenal neck length was 4 mm (range 0-9)...
August 29, 2016: Journal of Endovascular Therapy
Antony Bertrand-Grenier, Sophie Lerouge, An Tang, Eli Salloum, Eric Therasse, Claude Kauffmann, Hélène Héon, Igor Salazkin, Guy Cloutier, Gilles Soulez
OBJECTIVES: To investigate if shear wave imaging (SWI) can detect endoleaks and characterize thrombus organization in abdominal aortic aneurysms (AAAs) after endovascular aneurysm repair. METHODS: Stent grafts (SGs) were implanted in 18 dogs after surgical creation of type I endoleaks (four AAAs), type II endoleaks (13 AAAs) and no endoleaks (one AAA). Color flow Doppler ultrasonography (DUS) and SWI were performed before SG implantation (baseline), on days 7, 30 and 90 after SG implantation, and on the day of the sacrifice (day 180)...
August 29, 2016: European Radiology
Junjie Zou, Yuanyong Jiao, Xiwei Zhang, Jun Jiang, Hongyu Yang, Hao Ma
PURPOSE: To examine the safety, feasibility, and mid-term efficacy of the chimney technique for aortic arch pathologies. METHODS: From February 2011 to December 2014, a total of 35 patients (30 men; mean age 54.3 ± 14.1 years) with aortic arch pathologies underwent thoracic endovascular aortic repair combined with chimney stents. The indication was a proximal landing zone <1.5 cm. Follow-up was performed at 3, 6, and 12 months and then yearly thereafter...
November 2016: Cardiovascular and Interventional Radiology
Gustavo José Politzer Telles, Álvaro Razuk Filho, Walter Khegan Karakhanian, Paulo Fernandes Saad, Karen Ruggeri Saad, Jong Hun Park, Leticia Cristina Dalledone Siqueira, Roberto Augusto Caffaro
OBJECTIVE: Endovascular techniques to treat abdominal aortic aneurysms results in lower morbidity and mortality rates. However, dilation of the common iliac arteries prevents adequate distal sealing, which compromises the procedure success. The aim of this study is report the long-term outcomes of patients with abdominal aortic aneurysms associated with aneurysm of the common iliac artery following endovascular repair using a bifurcated bell-bottom stent graft. METHODS: This is a retrospective study that evaluated patients treated with bifurcated bell-bottom extension stent grafts to repair an infrarenal abdominal aortic aneurysm and who had at least one common iliac artery with dilatation > 1...
April 2016: Brazilian Journal of Cardiovascular Surgery
Q L Zeng, X Guo, X Y Huang, W H Wu, T Z Li, G R Liu, L Z Sun, L J Huang
OBJECTIVE: To evaluate the efficacy of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) on abdominal aortic aneurysm (AAA) patients complicating acute aortic syndrome (AAS). METHODS: Data of 17 patients (16 men, mean age (65.2±6.9) years old) , who underwent simultaneous TEVAR and EVAR between September 2010 and June 2015 in Beijing Anzhen Hospital, were retrospectively reviewed.All patients were diagnosed with concomitant AAA and AAS by preoperative CTA...
August 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Qiang Guo, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Guojun Zeng, Fei Xiong, Xiaojiong Du
PURPOSE: To analyze the literature comparing ultrasound [duplex (DUS) or contrast-enhanced (CEUS)] or magnetic resonance imaging (MRI) with computed tomography angiography (CTA) for endoleak detection and aneurysm diameter measurement after endovascular aneurysm repair (EVAR). METHODS: A systematic review identified 31 studies that included 3853 EVAR patients who had paired scans (DUS or CEUS vs CTA or MRI vs CTA) within a 1-month interval for identification of endoleaks during EVAR surveillance...
August 19, 2016: Journal of Endovascular Therapy
Adeline Schwein, Ponraj Chinnadurai, Jean Bismuth
PURPOSE: Retrograde perigraft access to the aneurysmal sac for type 2 endoleak embolization is a relevant alternative to standard transarterial and translumbar approaches. Entering the space between the graft and the iliac artery requires support and pushability, and might be challenging with standard endovascular catheters. CASE REPORT: We describe the case of a 78-year-old woman with an enlarging aneurysm due to type 2 endoleak, three years after EVAR. Despite multiple attempts at manual catheterization, we were unable to engage the space between the iliac wall and the stentgraft...
August 12, 2016: Annals of Vascular Surgery
Jesse M Manunga, Andrew Cragg, Ross Garberich, Jonathan A Urbach, Needa Skeik, Jason Alexander, Jessica Titus, Elliot Stephenson, Peter Alden, Timothy M Sullivan
OBJECTIVE: Type II endoleak is the most commonly encountered endoleak following endovascular abdominal aortic aneurysm repair (EVAR). Some have advocated preoperative inferior mesenteric artery (IMA) embolization as a valid method for reducing the incidence of this endoleak but controversies exist. We sought to demonstrate the impact of IMA embolization using a meta-analysis of currently available studies combined with our own experience. METHODS: We conducted an Institutional Board Review (IRB) approved, retrospective analysis of all patients undergoing IMA embolization prior to EVAR between the years 2010 and 2015 and used as a control a similar group of patients with patent IMA...
August 12, 2016: Annals of Vascular Surgery
M H Zhang, X Du, W Guo, X P Liu, X Jia, J Xiong, X H Ma, H P Zhang, Y L Xu, Y Wu, Y Y Ge
OBJECTIVE: To report experiences and results of complex aortic aneurysms involving the visceral arteries treating by total endovascular repair. METHODS: Seventy cases of thoracoabdominal aortic lesions treating by total endovascular repair in Department of Vascular Surgery, People's Liberation Army General Hospital from January 2011 to December 2014 were retrospectively analyzed. There were 47 cases underwent chimney technique, 6 underwent sandwich technique, 15 underwent fenestration technique and 2 underwent branched stent grafts technique...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Alexander Massmann, Nilo Javier Mosquera Arochena, Roushanak Shayesteh-Kheslat, Arno Buecker
OBJECTIVE: Endovascular anatomic reconstruction of iliac artery bifurcation in aorto-iliac aneurysms using commercial stentgrafts in sandwich-technique by bilateral transfemoral approach. METHODS: 24 patients (mean 73.8±standard deviation 6.8years) with complex aorto-iliac aneurysms (AAA): n=17; diameter 64±15 [48-100]mm; common-iliac-artery (CIA): n=27; 43±15 [30-87]mm; internal-iliac-artery (IIA): n=14; 28±8 [15-43]mm) were prospectively enrolled for EVAR with preservation of the IIA (n=31; bi-lateral n=7)...
November 1, 2016: International Journal of Cardiology
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