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Evar /tevar

B P Vierhout, R A Pol, M El Moumni, C J Zeebregts
OBJECTIVES: Cardiac and vascular surgery benefit from percutaneous interventions. Arteriotomy closure devices (ACDs) enable minimally invasive access to the common femoral artery (CFA). The objective of this review was to assess the differences between ACDs and surgical cut down (SCD) of the CFA regarding the number of complications, duration of surgery (DOS), and hospital length of stay (HLOS). DESIGN: A systematic literature search with predefined search terms was performed using MEDLINE, Embase, and the Cochrane Library (2000-2016)...
April 21, 2017: European Journal of Vascular and Endovascular Surgery
Rohit Philip Thomas, Tobias Kowald, Bernhard Schmuck, Osama Eldergash, Andreas Klausen, Valentin Dikov, Jerry Easo, Ajay Chavan
Introduction To evaluate the safety of percutaneous endovascular aortic repair and the relationship of access site characteristics to complications Materials and Methods All patients undergoing percutaneous TEVAR, EVAR and FEVAR procedures from January 2010 to May 2016 were retrospectively analysed for incidence of complications and their relationship to various access site characteristics like access artery size, degree of vessel calcification, skin to artery distance and sheath to artery ratio. Hemostasis occurring within 15 min after suture closure with or without manual compression was defined as primary hemostasis...
April 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Shen-Yen Lin, Sin-Yi Lyu, Ta-Wei Su, Sung-Yu Chu, Chien-Ming Chen, Chien-Fu Hung, Chee-Jen Chang, Po-Jen Ko
PURPOSE: To evaluate outcomes and predictive factors for additional ProGlide device deployment in percutaneous endovascular aortic repair (PEVAR) with the preclose technique. MATERIALS AND METHODS: Clinical data of patients who underwent PEVAR with the preclose technique from February 2012 to January 2015 were retrospectively reviewed. A total of 268 patients (229 men, 39 women) who underwent PEVAR (thoracic endovascular aortic repair [TEVAR], n = 113; endovascular abdominal aortic repair [EVAR], n = 152; simultaneous TEVAR and EVAR, n = 3) with 418 femoral access sites were enrolled...
February 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
Cheow Soon Chia, Luke Tay Hsien Tsung, John Wang Chaw Chian, Tze Tec Chong, Kiang Hiong Tay, Edward Choke Tieng Chek
We report a successful treatment of thoracic arch aneurysm using a combination of hybrid approach and a customized stent graft in a frail patient with challenging anatomy and concomitant large retrosternal goiter. The patient is an 82-year-old lady with multiple comorbidities who presented to her general practitioner for anorexia and significant weight loss. She was incidentally found to have a 6.6 cm saccular distal aortic arch aneurysm, a 5.5 cm infrarenal abdominal aortic aneurysm, and a large goiter adjacent to the left common carotid artery with retrosternal extension...
February 2, 2017: Annals of Vascular Surgery
Timothy Resch
Endovascular repair has a firmly established role in the treatment of aortic disease. The development of endovascular devices to treat even complex aortic disease has broadened the panorama of repair significantly but has also introduced new forms of repair failure. Standard devices for EVAR and TEVAR have also been enhanced, providing better adaptation to the anatomy treated, smaller delivery systems, more intuitive delivery designs as well as improved features to facilitate precise delivery of the device...
April 2017: Journal of Cardiovascular Surgery
Beatrice Fiorucci, Nikolaos Tsilimparis, Fiona Rohlffs, Franziska Heidemann, Sebastian E Debus, Tilo Kölbel
Endovascular repair has become the treatment of choice for thoracic and abdominal aortic pathologies in the last decades, and is associated with excellent results in terms of perioperative, mid- and long-term morbidity and mortality. Access vessels play a central role in these procedures since access-related issues can increase the rates of technical failures and determine clinical complications for the patient. Therefore, accurate preoperative clinical evaluation and review of the preoperative images are mandatory...
April 2017: Journal of Cardiovascular Surgery
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
April 2017: Journal of Cardiovascular Surgery
Yuanyuan Guo, Hongbo Cai, Bin Yang, Hui Jin
BACKGROUND: To analyze information from a single clinical center, evaluating early and midterm results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for coexisting thoracic and abdominal aortic pathologies. METHODS: From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years; range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR...
November 27, 2016: Annals of Vascular Surgery
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
BACKGROUND: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infrarenal aorta using custom-made bovine pericardium grafts...
November 27, 2016: Annals of Vascular 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
Qinglong Zeng, Xi Guo, Lianjun Huang, Lizhong Sun
Objective To evaluate the efficacy and outcomes of simultaneous thoracic endovascular aortic repair (TEVAR) and abdominal endovascular aneurysm repair (EVAR). Methods A total of 21 patients (20 men; mean 65 ± 7 years, range 54-77) underwent simultaneous TEVAR and EVAR between September 2010 and June 2015 at a single center were retrospectively reviewed. All patients had concomitant thoracic pathologies (aneurysm, penetrating aortic ulcer, intramural hematoma, or dissection) and abdominal aortic aneurysm...
January 1, 2016: Vascular
Anahita Dua, Jason Andre, Nicholas Nolte, James Pan, Douglas Hood, Kim J Hodgson, Sapan S Desai
BACKGROUND: Endovascular aneurysm repair (EVAR) and Thoracic endovascular aortic repair (TEVAR) are commonly performed by interventional radiologists, cardiologists, general surgeons, cardiothoracic surgeons, and vascular surgeons, with each specialty having differences in residency structure, operative experience, and subspecialty training. The aim of this study is to evaluate the impact of surgeon specialty on outcomes following EVAR and TEVAR. METHODS: Patients who underwent EVAR and TEVAR were identified from the 2007 to 2009 Nationwide Inpatient Sample (NIS)...
August 2016: Annals of Vascular Surgery
Artai Pirouzram, Tal Martin Hörer, Thomas Larzon
Successful endovascular aortic repair is highly dependent on the quality of the iliac access vessels. Patients with poor access vessels can be turned down from endovascular aortic repair or thoracic endovascular aortic repair by the treating physician. Perioperative complications such as failure to deliver the device or iliac rupture can be addressed to improper access vessels. In this article, we describe a novel technique to access the common iliac artery when access vessels are poor in diameter or quality...
March 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Ryosuke Yoshiga, Koichi Morisaki, Yutaka Matsubara, Keiji Yoshiya, Kentaro Inoue, Daisuke Matsuda, Yukihiko Aoyagi, Shinichi Tanaka, Jun Okadome, Takuya Matsumoto, Yoshihiko Maehara
We report a case of acute type B aortic dissection with the complication of bowel ischemia and abdominal stent graft compression treated by emergency thoracic aortic stent grafting after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). A 69-year-old male was admitted to our hospital for sudden thoraco-abdominal pain. He had past treatment history of EVAR for AAA half a year ago. A computed tomography (CT) showed acute type B aortic dissection, and conservative treatment was initially performed...
December 2015: Surgical Case Reports
Matthew R Smeds, Audra A Duncan, Michael P Harlander-Locke, Peter F Lawrence, Sean Lyden, Javariah Fatima, Mark K Eskandari
OBJECTIVE: This study examined the medical and surgical management and outcomes of patients with aortic endograft infection after abdominal endovascular aortic repair (EVAR) or thoracic endovascular aortic repair (TEVAR). METHODS: Patients diagnosed with infected aortic endografts after EVAR/TEVAR between January 1, 2004, and January 1, 2014, were reviewed using a standardized, multi-institutional database. Demographic, comorbidity, medical management, surgical, and outcomes data were included...
February 2016: Journal of Vascular Surgery
Konstantinos G Moulakakis, Spyridon N Mylonas, John Kakisis, Nikolaos P E Kadoglou, Ioannis Papadakis, George S Sfyroeras, Constantine C N Antonopoulos, George Mantas, Ignatios Ikonomidis, Christos D Liapis
Endovascular abdominal aortic aneurysm repair (EVAR) and thoracic aortic aneurysm repair (TEVAR) have been widely incorporated into clinical practice. However, changes in arterial stiffness and post-implantation syndrome after aortic endografting remain important issues under investigation. The aneurysm sac wall motion after successful EVAR and TEVAR reflects complex interactions between all the components of the excluded aneurysm, including true compliance of the aneurysm wall itself, intra-aneurysm sac pressure, remodeling of the thrombus, and mechanical characteristics of the endograft...
April 2015: Aorta (Stamford, Conn.)
Yoshihiro Haga, Kouichi Chida, Yuji Kaga, Kazuhisa Saitou, Takeshi Arai, Shinichi Suzuki, Yoshimi Iwaya, Eriko Kumasaka, Nozomi Kataoka, Naoto Satou, Mitsuya Abe
In recent years, aortic aneurysm treatment with stent graft grafting in the X-ray fluoroscopy is increasing. This is an endovascular therapy, because it is a treatment which includes the risk of radiation damage, having to deal with radiation damage, to know in advance is important. In this study, in order to grasp the trend of exposure stent graft implantation in a hybrid operating room (OR) system, focusing on clinical data (entrance skin dose and fluoroscopy time), was to count the total. In TEVAR and EVAR, fluoroscopy time became 13...
December 2015: Nihon Hoshasen Gijutsu Gakkai Zasshi
Sheela Pai Cole
The patient with thoracic aortic disease can present for open or endovascular repair. Thoracic endovascular aortic repair (TEVAR) has emerged as a minimally invasive option for a multitude of aortic pathology, including dissections, aneurysms, traumatic injuries, and ulcers. Postoperative management of these patients depends on the extent of procedure, whether it was open or endovascular, and, finally, on the preoperative comorbidities present. While procedural success has catapulted TEVAR to popularity, midterm results have been mixed...
December 2015: Seminars in Cardiothoracic and Vascular Anesthesia
Alexandros Mallios, Rob Brown, John Blebea
The axillary artery approach has been used for access for complex endovascular aortic procedures such as thoracic endovascular aortic repair with poor anatomy for traditional deployment as well as for fenestrated and branched abdominal aortic endografts. We report the first case of an iliac graft limb deployment through the axillary artery during an endovascular aortic repair for maintenance of anterograde internal iliac flow in a patient with a symptomatic abdominal aortic aneurysm and chronic occlusion of both the external iliac and common femoral arteries...
February 2016: Annals of Vascular Surgery
Anne Lejay, Thibault Caspar, Mickaël Ohana, Charline Delay, Elie Girsowicz, P Ohlmann, Fabien Thaveau, Bernard Geny, Yannick Georg, Nabil Chakfe
Endovascular procedures, such as transcatheter aortic valve implantation (TAVI), thoracic endovascular aortic repair (TEVAR), and endovascular abdominal aortic repair (EVAR) have been established as promising less invasive therapeutic options. However, despite continuous advances and device improvements, the use of large-sheaths still remains an important challenge, since significant coexisting arterial disease may be encountered in patients undergoing such procedures. Identification of coexisting arterial diseases by optimal preoperative imaging assessment is essential to anticipate these difficulties and avoid the complications by using adequate access options...
April 2016: Journal of Cardiovascular Surgery
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