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Vascular endovascular endograft aneurysm repair endoleaks

Seline R Goudeketting, Kim van Noort, Kenneth Ouriel, William D Jordan, Jean M Panneton, Cornelis H Slump, Jean-Paul P M de Vries
OBJECTIVE: This study sought to quantify EndoAnchor (Medtronic Vascular, Santa Rosa, Calif) penetration into the aortic wall in patients undergoing endovascular abdominal aortic aneurysm repair and to assess predictors of successful penetration and its relationship to postprocedural type IA endoleak. METHODS: A subset of patients from the Aneurysm Treatment Using the Heli-FX Aortic Securement System Global Registry (ANCHOR) were included if they met the following criteria: the indication for EndoAnchor use was to treat a type IA endoleak, and postprocedure contrast-enhanced computed tomography (CT) scans of sufficient quality were available for core laboratory review...
April 21, 2018: Journal of Vascular Surgery
Sriharsha Gummadi, John R Eisenbrey, Andrej Lyshchik
Endovascular repair of abdominal aortic aneurysms have been performed successfully since 1991. However, 20% to 50% of these patients may develop an endoleak or continued aneurysmal sac expansion or perfusion despite stent graft coverage. Current recommendations suggest lifelong surveillance with computed tomographic angiography (CTA) at least 1 month after intervention and yearly after that. In select patients with a stable aneurysm sac on computed tomography performed 1 year after treatment, future screening could be performed with ultrasonography...
March 29, 2018: Ultrasound Quarterly
Enrico Gallitto, Mauro Gargiulo, Gianluca Faggioli, Alessia Sonetto, Chiara Mascoli, Rodolfo Pini, Mohamhed Abualhin, Andrea Stella
PURPOSE: To describe an endovascular technique to close a renal artery fenestration during fenestrated endograft implant for a pararenal abdominal aortic aneurysm (p-AAA) without interfering with other visceral vessels. REPORT: A 76-year-old man with p-AAA underwent repair by a 4 fenestrations custom-made endograft. At the intraprocedural angiography, the right renal artery was occluded. To avoid a high-flow endoleak from fenestration, we performed the following technique: a 9F-steerable sheath was used to advance a 7F sheath through the fenestration into aneurism...
February 5, 2018: Annals of Vascular Surgery
Bruno Gossetti, Ombretta Martinelli, Michelangelo Ferri, Roberto Silingardi, Fabio Verzini
OBJECTIVE: Because of advances in technology and experience of the operator, endovascular aneurysm repair (EVAR) has supplanted open repair to treat abdominal aortic aneurysm (AAA). The low 30-day mortality and morbidity of EVAR make the endovascular approach particularly suitable for patients at high surgical risk. However, endoleak or endograft migration requiring secondary intervention or open surgical conversion is a limitation of EVAR. The Nellix system (Endologix, Inc, Irvine, Calif) has been designed to seal the entire AAA to overcome these limitations with EVAR...
December 11, 2017: Journal of Vascular Surgery
S L Zettervall, S E Deery, P A Soden, K Shean, J J Siracuse, M Alef, V I Patel, M L Schermerhorn
BACKGROUND: Previous studies comparing endografts with suprarenal and infrarenal fixation for endovascular abdominal aortic aneurysm repair (EVAR) have found conflicting results and did not account for differences in patient selection. This study aims to evaluate the differences in outcomes among surgeons who routinely use either suprarenal or infrarenal fixation, as well as all surgeons in the Vascular Study Group of New England (VSGNE). METHODS: All patients undergoing EVAR in the VSGNE from 2003 to 2014 were identified...
September 2017: European Journal of Vascular and Endovascular Surgery
Rutger A Stokmans, Pieter P H L Broos, Marc R H M van Sambeek, Joep A W Teijink, Philippe W M Cuypers
BACKGROUND: Endovascular aneurysm repair of aortoiliac or iliac aneurysms is often performed with stent graft coverage of the origin of the hypogastric artery (HA) to ensure adequate distal seal. It is considered common practice to perform adjunctive coiling of the HA to prevent a type II endoleak. Our objective was to question the necessity of pre-emptive coiling by comparing the outcomes of HA coverage with and without prior coil embolization. METHODS: Data from the Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE), which prospectively enrolled 1263 endovascular aneurysm repair patients between March 2009 and April 2011 from multiple centers worldwide, were used for this study...
January 2018: Journal of Vascular Surgery
Claudio Bianchini Massoni, Antonio Freyrie, Mauro Gargiulo, Tiziano Tecchio, Chiara Mascoli, Enrico Gallitto, Gianluca Faggioli, Rodolfo Pini, Matteo Azzarone, Paolo Perini, Andrea Stella
BACKGROUND: The aim of the study is to report early and follow-up outcomes of the endovascular treatment with iliac endografts for isolated iliac artery aneurysms (IIAAs). METHODS: Records of patients who underwent elective endovascular repair for IIAA (both primary and para-anastomotic) from 2005 to 2015 in 2 Italian centers were retrospectively examined. Demographic data, preoperative patient comorbidities, iliac aneurysm characteristics, contralateral iliac axis involvement, patency of hypogastric arteries and inferior mesenteric artery (IMA), and data of endovascular treatment were obtained for analysis...
October 2017: Annals of Vascular Surgery
Ryan A Shutze, Wes Oglesby, Allen Lee, William P Shutze
Patients undergoing endovascular repair (EVAR) of aortoiliac or iliac artery aneurysm may require sacrifice of one or both internal iliac arteries (IIAs). Until Food and Drug Administration-approved commercial grafts became available, endovascular IIA preservation was accomplished using the "sandwich" technique, but limited information is available regarding the results of this method. After obtaining institutional review board approval, we identified patients undergoing IIA preservation with the sandwich technique during EVAR at our institution...
January 2017: Proceedings of the Baylor University Medical Center
J L De Bruin, J R Brownrigg, B O Patterson, A Karthikesalingam, P J Holt, R J Hinchliffe, I M Loftus, M M Thompson
BACKGROUND: The chimney technique using parallel grafts offers an alternative to fenestrated or branched endovascular solutions for juxtarenal and suprarenal aneurysms. Endograft deployment proximal to the renal or visceral ostia is combined with parallel stents to the aortic side branches. Application of the chimney technique using the Nellix device (Ch-EVAS) may offer some potential advantages with respect to the seal between the endograft and the parallel grafts. This study aimed to investigate the feasibility and efficacy of the Nellix endovascular aneurysm sealing (EVAS) system in conjunction with parallel grafts for the treatment of juxtarenal and suprarenal aneurysms...
October 2016: European Journal of Vascular and Endovascular Surgery
Gary W Lemmon, Rahgu L Motaganahalli, Tiffany Chang, James Slaven, Ben Aumiller, Bradford J Kim, Michael C Dalsing
OBJECTIVE: Type III (T-III) endoleaks following endovascular aneurysm repair (EVAR) remain a major concern. Our center experienced a recent concentration of T-III endoleaks requiring elective and emergency treatment and prompted our review of all EVAR implants over a 40-month period from April 2011 until August 2014. This report represents a single center experience with T-III endoleak management with analysis of factors leading to the T-III-related failure of EVAR. METHODS: A retrospective review of all the operative reports, medical records, and computed tomography scans were reviewed from practice surveillance...
September 2016: Journal of Vascular Surgery
Maarten K Dinkelman, Simon P Overeem, Dittmar Bockler, Jean P DE Vries, Jan M Heyligers
BACKGROUND: Juxtarenal aortic aneurysms (JAAs) pose clinical challenges for vascular specialists. Chimney endovascular sealing (Ch-EVAS) might be an ideal endovascular solution in the treatment of JAAs. We present technical aspects and early clinical results of a multicenter experience with Ch-EVAS. METHODS: This was a retrospective, multicenter study. Between November 2014 and March 2016, 16 patients underwent elective endovascular repair of JAAs with Ch-EVAS of 1 or 2 renal and/or superior mesenteric artery vessels...
October 2016: Journal of Cardiovascular Surgery
Tze-Woei Tan, Mohammed Eslami, Denis Rybin, Gheorghe Doros, Wayne W Zhang, Alik Farber
BACKGROUND: Type I endoleak (TIE) during endovascular aneurysm repair (EVAR) is usually identified and treated intraoperatively. We evaluated the outcomes of patients who, despite possible treatment, had TIE at completion of EVAR. METHODS: We examined consecutive EVAR for nonruptured abdominal aortic aneurysm (AAA) within the Vascular Study Group of New England database (2003-2012) and compared the outcomes of patients who had TIE at completion with those who did not...
June 2016: Journal of Vascular Surgery
Brajesh K Lal, Wei Zhou, Ziyi Li, Tassos Kyriakides, Jon Matsumura, Frank A Lederle, Julie Freischlag
OBJECTIVE: The Veterans Affairs Open Versus Endovascular Repair (OVER) Trial of Abdominal Aortic Aneurysms study was a randomized controlled trial comparing open vs endovascular repair (EVAR) in standard-risk patients with infrarenal aortic aneurysms. The analysis reported here identifies characteristics, risk factors, and long-term outcome of endoleaks in patients treated with EVAR in the OVER cohort. METHODS: The OVER trial enrolled 881 patients, of whom 439 received successful EVAR...
December 2015: Journal of Vascular Surgery
Shinichi Iwakoshi, Shigeo Ichihashi, Hirofumi Itoh, Nobuoki Tabayashi, Shoji Sakaguchi, Takeshi Yoshida, Yoshihisa Nakao, Kimihiko Kichikawa
OBJECTIVE: Thoracic endovascular aneurysm repair (TEVAR) for the aortic arch aneurysm is challenging because of its curved anatomic configuration and the presence of the supra-aortic branches. The Najuta fenestrated endograft (Kawasumi Laboratories, Inc, Tokyo, Japan) was developed to treat aortic arch diseases, offering maximal proximal landing length while preserving the blood flow to the supra-aortic branches. We evaluated the perioperative and midterm outcomes of this fenestrated endograft...
December 2015: Journal of Vascular Surgery
Daniela Mazzaccaro, Maria Teresa Occhiuto, Silvia Stegher, Paolo Righini, Giovanni Malacrida, Giovanni Nano
BACKGROUND: Recently, the new Cordis INCRAFT abdominal aortic aneurysm (AAA) Stent-Graft System ultra low-profile device has been introduced in the clinical practice of endovascular aortic repair (EVAR) for the treatment of infrarenal AAAs (iAAAs). In our operative unit, it has been used since November 2014. We report our initial experience with the use of this novel device. We further discuss some technical aspects about the use of the endograft. METHODS: Data of all patients undergoing elective EVAR in our Division of Vascular Surgery using the Cordis INCRAFT AAA Stent-Graft System from November 2014 till now were retrospectively collected in a database and outcomes reviewed...
January 2016: Annals of Vascular Surgery
Mahmoud B Malas, William D Jordan, Michol A Cooper, Umair Qazi, Adam W Beck, Michael Belkin, William Robinson, Mark Fillinger
OBJECTIVE: This study compared the performance of the Aorfix endograft (Lombard Medical, Oxfordshire, United Kingdom) in standard (<60°), highly angled (60°-90°), and severely angled (>90°) aortic necks in the PYTHAGORAS study and evaluated changes in neck morphology over time. METHODS: PYTHAGORAS is a prospective nonrandomized clinical trial of the Aorfix endograft. We divided the endovascular aneurysm repair (EVAR) cohort into groups by standard, high, and severe neck angle...
November 2015: Journal of Vascular Surgery
N Mangialardi, S Ronchey, A Malaj, S Fazzini, V Alberti, V Ardita, M Orrico, M Lachat
AIM: The endovascular debranching with chimney stents provides a minimally invasive alternative to open surgery with readily available devices and has extended the option of endoluminal therapy into the realm of the aortic arch. But a critical observation at the use of this technique at the aortic arch is important and necessary because of the lack of long-term results and long term patency of the stents. Our study aims to review the results of chimney grafts to treat arch lesions. METHODS: A systematic health database search was performed in December 2014 according to the Prisma Guidelines...
August 2015: Journal of Cardiovascular Surgery
A Hertault, B Maurel, F Pontana, T Martin-Gonzalez, R Spear, J Sobocinski, I Sediri, C Gautier, R Azzaoui, M Rémy-Jardin, S Haulon
OBJECTIVES: This study evaluated a new strategy to assess technical success after standard and complex endovascular aortic repair (EVAR), combining completion contrast enhanced cone beam computed tomography (ceCBCT) and post-operative contrast enhanced ultrasound (CEUS). METHODS: Patients treated with bifurcated or fenestrated and branched endografts in the hybrid room during the study period were included. From December 2012 to July 2013, a completion angiogram (CA) was performed at the end of the procedure, and computed tomography angiography (CTA) before discharge (group 1)...
May 2015: European Journal of Vascular and Endovascular Surgery
C J Buckley, S D Buckley
Endovascular aortic aneurysm repair (EVAR) has currently replaced open surgical repair as the primary method for treating aneurysm disease of the abdominal aorta and common iliac artery. Current EVAR devices, despite undergoing multiple improvement iterations, continue to have relatively high secondary intervention rates. Device migration, endoleak and limb occlusion continue to be challenges not completely met by any of the current devices. Investigational devices presently in clinical trials may provide significant resolution for many of the identified endograft deficiencies...
June 2015: Journal of Cardiovascular Surgery
Jared Kray, Spencer Kirk, Jan Franko, David K Chew
OBJECTIVE: Endovascular repair (EVAR) of infrarenal aortic aneurysms (AAA) is increasingly used in patients with suitable aortic morphology conforming to device-specific instructions for use. Despite improvements in graft design, type II endoleak (EL-2) from the inferior mesenteric artery (EL-IMA) or the lumbar artery (EL-LA) remains the Achilles' heel of EVAR. The objective of this study was to evaluate the natural history of the AAA sac after EVAR. We hypothesized that persistent EL-2 would be associated with inferior AAA sac volume regression...
April 2015: Journal of Vascular Surgery
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