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Hyangkyoung Kim, Kwangjin Lee, Sungsin Cho, Jin Hyun Joh
BACKGROUND: In endovascular procedures including total percutaneous endovascular aneurysm repair (pEVAR), percutaneous access through the common femoral artery is most commonly performed. Access-site bleeding is a major concern in percutaneous techniques. Herein, we present a case of successful control of continuous oozing using a vascular closure device (VCD) and the application of Surgicel (Johnson & Johnson, United States) over the access tract. CASE SUMMARY: An 82-year-old man presented with an unruptured abdominal aortic aneurysm measuring 83 mm × 75 mm...
December 6, 2022: World Journal of Clinical Cases
#2
JOURNAL ARTICLE
Shirli Tay, Mohamed S Zaghloul, Mehreen Shafqat, Chao Yang, Kshitij A Desai, Gayan De Silva, Luis A Sanchez, Mohamed A Zayed
PURPOSE: The PEVAR Trial demonstrated that compared to open femoral exposure, elective percutaneous endovascular AAA repair (ePEVAR) is associated with decreased perioperative morbidity and access site complications. We hypothesized that PEVAR for ruptured AAA (rPEVAR) may also improve perioperative morbidity compared to open femoral exposure (rEVAR). There are currently no reports that evaluate the utility and outcomes of rPEVAR. MATERIALS AND METHODS: From 2015 to 2021, all patients who underwent an endovascular repair of a ruptured AAA at a single institution were included in the study and grouped into rPEVAR and rEVAR...
2022: Frontiers in Surgery
#3
JOURNAL ARTICLE
Jacob Budtz-Lilly, Mario D'Oria, Enrico Gallitto, Luca Bertoglio, Tilo Kölbel, David Lindström, Nuno Dias, Goran Lundberg, Dittmar Böckler, Gianbattista Parlani, Michele Antonello, Gian F Veraldi, Nikolaos Tsilimparis, Drosos Kotelis, Philip Dueppers, Giovanni Tinelli, Arnaldo Ippoliti, Paolo Spath, Antonino Logiacco, Geert Willem H Schurink, Roberto Chiesa, Alessandro Grandi, Giuseppe Panuccio, Fiona Rohlffs, Anders Wanhainen, Kevin Mani, Angelos Karelis, Björn Sonesson, Magnus Jonsson, Alina-Marilena Bresler, Gioele Simonte, Giacomo Isernia, Andrea Xodo, Luca Mezzetto, Davide Mastrorilli, Carlota F Prendes, Basel Chaikhouni, Alexander Zimmermann, Sandro Lepidi, Mauro Gargiulo, Barend Mees, Jon Unosson
OBJECTIVE: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR). METHODS: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006 to 2021 from 17 European vascular centers were analyzed. Endpoints included technical success, major adverse events, 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm...
August 1, 2023: Annals of Surgery
#4
JOURNAL ARTICLE
Brittany C Montross, Monica S O' Brien-Irr, Sikandar Z Khan, Hasan H Dosluoglu, Mariel Rivero, Linda M Harris, Gregory Cherr, Maciej L Dryjski
BACKGROUND: Evaluate outcomes following urinary catheter (UC) versus no urinary catheter (NUC) insertion in elective endovascular repair (EVAR) of abdominal aortic aneurysm (AAA). METHODS: Retrospective record review of all elective EVAR at a university affiliated medical center over a 5-year period. Statistical analysis included Chi Sq, Independent Student t Test. RESULTS: Six surgeons performed 272 elective EVAR. Three surgeons preferred selective insertion of indwelling UC, such that 86 (32%) EVAR were completed without indwelling urinary catheters (NUC)...
May 2022: Annals of Vascular Surgery
#5
JOURNAL ARTICLE
Guoshan Bi, Quanwen Wang, Guozuo Xiong, Jie Chen, Dongyang Luo, Jiangbei Deng, Xiao Qin
OBJECTIVE: The objective is to investigate whether percutaneous access (pEVAR) is superior to cutdown access (cEVAR) in terms of safety and efficacy during endovascular repair of abdominal aortic aneurysms (AAAs). METHODS: We searched PubMed, Embase, and Cochrane Library from January 1999 to December 2020 for studies reporting on the comparison between percutaneous and cutdown techniques for endovascular repair of AAAs. Outcomes evaluated were technical success rates, access site-related complications and operative time, and hospital stay...
October 2022: Vascular
#6
JOURNAL ARTICLE
Joshua P Kronenfeld, Emily L Ryon, Alex Lall, Naixin Kang, Stefan Kenel-Pierre, Hilene DeAmorim, Jorge Rey, John Karwowski, Arash Bornak
OBJECTIVES: To report our experience and compare the results of percutaneous endovascular aortic aneurysm repair (PEVAR) performed under monitored anesthesia care (MAC) to PEVAR under general anesthesia (GA). METHODS: A retrospective review of patients who underwent non-emergency endovascular abdominal aortic aneurysm repair (EVAR) was completed. Patients were excluded if they had a complex repair, including fenestrated, branched, or parallel endografting. Demographics, operative data, 30-day mortality/morbidity and postoperative outcomes were analyzed...
June 2022: Vascular
#7
JOURNAL ARTICLE
Yu-Hsien Lee, Ta-Wei Su, I-Hao Su, Sheng-Yueh Yu, Ming-Yi Hsu, Chun-Hsien Hsin, Wen-Cheng Wei, Sung-Yu Chu, Jeng-Hwei Tseng, Po-Jen Ko
PURPOSE: To evaluate the short-term outcome of totally percutaneous endovascular aortic repair (pEVAR) of ruptured abdominal aortic aneurysms (AAAs) compared with femoral cut-down endovascular aortic repair (cEVAR). MATERIALS AND METHODS: The medical records of patients with ruptured AAAs that underwent EVAR between March 2010 and April 2017 were retrospectively reviewed. Demographic information, preoperative vital signs, preoperative laboratory data, method of anesthesia, procedure duration, aneurysm morphology, brand of device used, length of hospital stay, access complications, and short-term outcomes were recorded...
January 27, 2021: Annals of Vascular Surgery
#8
JOURNAL ARTICLE
Tzu-Chin Lo, Chun-Hsien Hsin, Ren-Fu Shie, Sheng-Yueh Yu, Sung-Yu Chu, Po-Jen Ko, I-Hao Su, Ming-Yi Hsu, Chien Ming Chen, Ta-Wei Su
PURPOSE: To evaluate the safety of outpatient percutaneous endovascular abdominal aortic repair (PEVAR) versus inpatient PEVAR without or with adjunct procedures. MATERIALS AND METHODS: Between January 2012 and June 2019, a cohort of 359 patients comprising 168 (46.8%) outpatients and 191 (53.2%) inpatients who had undergone PEVAR were enrolled. All the patients were asymptomatic but had indications for endovascular aortic repair, ie, fit for intravenous anesthesia and anatomically feasible with standard devices...
December 14, 2020: Journal of Vascular and Interventional Radiology: JVIR
#9
JOURNAL ARTICLE
Brittany C Montross, Monica S O'Brien-Irr, Dimitrios Koudoumas, Sikandar Z Khan, Mariel Rivero, Linda M Harris, Hasan H Dosluoglu, Gregory S Cherr, Maciej L Dryjski
OBJECTIVES: To identify candidates undergoing elective endovascular aneurysm repair (EVAR) of asymptomatic infrarenal abdominal aortic aneurysm who are eligible for early (≤6 hours) hospital discharge or to have EVAR performed in free-standing ambulatory surgery centers. METHODS: A retrospective medical record review of all elective EVAR performed at a university medical center over 5 years was undertaken. Potential candidates for early discharge or to have EVAR performed in a free-standing ambulatory surgery setting were defined as those who used routine monitoring services only or had self-limited minor adverse events (AE) that were identified, treated, and resolved within 6 hours of surgery...
October 2020: Journal of Vascular Surgery
#10
COMPARATIVE STUDY
John Phair, Matthew Carnevale, Dov Levine, Evan C Lipsitz, Larry Scher, Saadat Shariff, Karan Garg
BACKGROUND: With increased focus on the opioid crisis, it was our goal to describe rates and risk factors for postoperative use of opioids in patients undergoing abdominal aortic aneurysm (AAA) repair as well as identify pain modalities that are underutilized. METHODS: We retrospectively analyzed perioperative analgesic prescriptions for endovascular (EVAR) and open AAA repair between January 1, 2010 and January 1, 2018. Patients' baseline opioid use, demographics, and medical comorbidities were obtained...
October 2020: Annals of Vascular Surgery
#11
Bradley M White, Dustin L Meyer, Aswin Kumar, Curtis L Anderson
Percutaneous endovascular aneurysm repair (PEVAR) is a minimally invasive treatment option for patients with abdominal aortic aneurysms (AAA). PEVAR allows for the lower incidence of vascular access site complications and decreased procedure time, yet the utility of this technique depends on the anatomical characteristics of the aneurysm. A detailed evaluation of the access site vessels and aneurysm neck anatomy are critical for standard patient and device selection. An 84-year-old male presented to our institution with the sudden onset of abdominal pain and confusion...
July 11, 2019: Curēus
#12
COMPARATIVE STUDY
Jacob S Thurston, Alhaji Camara, Nathan Alcasid, Sarah B White, Parag J Patel, Peter J Rossi, Robert E Hieb, Cheong J Lee
BACKGROUND: The objective of this study was to assess cost differences between patients who underwent percutaneous endovascular aortic repair (PEVAR) and open surgical femoral exposure in elective endovascular aortic repair (EVAR) of abdominal aortic aneurysms. MATERIALS AND METHODS: An IRB-approved single center retrospective analysis of patients who underwent elective EVAR for abdominal aortic aneurysms from 2009 to 2016 was performed. One hundred patients were selected with 50 patients who underwent PEVAR and 50 patients who underwent open surgical femoral exposure...
August 2019: Journal of Surgical Research
#13
REVIEW
Graham Roche-Nagle, Maureen Hazel, Dheeraj K Rajan
OBJECTIVES: The percutaneous endovascular abdominal aortic repair (PEVAR) approach is a minimally invasive technique that has demonstrated clinical benefit over traditional surgical cut down associated with standard endovascular abdominal aortic aneurysm (AAA) repair (EVAR). The objective of our study was to evaluate the budget impact to a Canadian hospital of changing the technique for AAA repair from the EVAR approach to the PEVAR approach. METHODS: We examined the budget impact of replacing the EVAR approach with the PEVAR approach in a Canadian hospital that performs 100 endovascular AAA repairs annually...
May 2018: Canadian Association of Radiologists Journal
#14
JOURNAL ARTICLE
B D K Leong, N Govindarajanthran, T M Hafizan, K L Tan, H Hanif, A A Zainal
INTRODUCTION: There has been a paradigm shift in the treatment of AAA with the advent of endovascular aneurysm repair (EVAR). Rapid progress and evolution of endovascular technology has brought forth smaller profile devices and closure devices. Total percutaneous endovascular aneurysm repair (pEVAR) involves the usage of suture-mediated closure devices (SMCDs) at vascular access sites to avoid a traditional surgical cutdown. MATERIALS AND METHODS: We retrospectively reviewed our experience of pEVAR between April 2013 and July 2014...
April 2017: Medical Journal of Malaysia
#15
COMPARATIVE STUDY
Christopher J Agrusa, Andrew J Meltzer, Darren B Schneider, Peter H Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly used in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in most cases. The purpose of this study was to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
August 2017: Annals of Vascular Surgery
#16
COMPARATIVE STUDY
David S Kauvar, Eric D Martin, Matthew D Givens
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has become accepted as a suitable alternative to open EVAR (OEVAR) in the treatment of abdominal aortic aneurysms (AAAs). Direct comparisons between the 2 techniques have been infrequently reported and have predominantly focused on immediate procedural outcomes. The objective of this study was to compare contemporary 30-day postoperative outcomes between successfully completed elective PEVAR and OEVAR. METHODS: The 2012 National Surgical Quality Improvement Program database was queried for all elective primary AAA repairs...
February 2016: Annals of Vascular Surgery
#17
COMPARATIVE STUDY
Dominique B Buck, Eleonora G Karthaus, Peter A Soden, Klaas H J Ultee, Joost A van Herwaarden, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Prior studies suggest that percutaneous access for endovascular abdominal aortic aneurysm repair (pEVAR) offers significant operative and postoperative benefits compared with femoral cutdown (cEVAR). National data on this topic, however, are limited. We compared patient selection and outcomes for elective pEVAR and cEVAR. METHODS: We identified all patients undergoing either pEVAR (bilateral percutaneous access, whether successful or not) or cEVAR (at least one planned groin cutdown) for abdominal aortic aneurysms from January 2011 to December 2013 in the Targeted Vascular data set from the American College of Surgeons National Surgical Quality Improvement Program database...
July 2015: Journal of Vascular Surgery
#18
JOURNAL ARTICLE
M Tóth, J Maďarič, T Balázs, J Mikuláš, D Hladíková, R Bažík, E Drangová, T Urlandová, A Klepanec, I Vulev
INTRODUCTION: Endovascular abdominal aortic aneurysm repair (EVAR) is a modern and, compared to conventional open surgery, less invasive therapeutic strategy with short-term lower morbidity and mortality. The aim of our retrospective analysis was the assessment of safety, technical success, short-term and mid-term results of elective patients scheduled for total percutaneous EVAR implantation (PEVAR). MATERIAL AND METHODS: One hundred and sixteen consecutive patients (M:F 104:12, age 71±9 years, maximum AAA diameter 60±14mm) underwent elective PEVAR between January 2009 and August 2012...
December 2013: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
#19
JOURNAL ARTICLE
Marek Iłżecki, Tomasz Zubilewicz, Piotr Terlecki, Stanisław Przywara
UNLABELLED: The aim of the study was to thoroughly evaluate the closure device ProStar XL in terms of its efficiency and safety in the percutaneous endovascular treatment of abdominal aortic aneurysms in the infrarenal section of the body. Additionally, it was crucial to assess if there were any occurrences of regional complications at any step of the procedure. It was also important to stipulate the estimated hospitalization period as well as the overall cost of the PEVAR treatment with the use of ProStar XL...
October 2013: Polski Przeglad Chirurgiczny
#20
JOURNAL ARTICLE
N Mangialardi, S Ronchey, H Kasemi, V Alberti, S Fazzini, E Serrao
AIM: Aim of the study was to report our single-center experience of the ultra-low profile OvationTM Abdominal Stent-Graft System with totally percutaneous endovascular aneurysm repair (PEVAR). METHODS: Between December 2010 and March 2013 we electively treated 35 patients (male: 89%, mean age: 73±7 years) with abdominal aortic aneurysm (AAA) using bilateral PEVAR with the OvationTM endograft. Most (77%) cases were characterized by challenging femoral artery anatomy...
October 2013: Journal of Cardiovascular Surgery
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