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Vascular endovascular endograft aneurysm repair endoleaks

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
Antonio Freyrie, Enrico Gallitto, Mauro Gargiulo, Gianluca Faggioli, Claudio Bianchini Massoni, Chiara Mascoli, Rodolfo Pini, Andrea Stella
OBJECTIVE: The objective of this study was to evaluate early and late results of the Anaconda aortic endograft (Vascutek, Terumo, Inchinnan, Scotland) in a single-center experience. METHODS: From September 2005 to March 2012, patients underwent endovascular aortic repair for abdominal aortic aneurysm (AAA) with Anaconda endograft were prospectively enrolled in a dedicated database. Demographic and aortoiliac morphological data were considered. Preoperative planning was based on thoracoabdominal and pelvic computed tomography angiography...
November 2014: Journal of Vascular Surgery
David C Ormesher, Christopher Lowe, Nicola Sedgwick, Charles N McCollum, Jonathan Ghosh
BACKGROUND: Iodinated contrast during endovascular aneurysm repair (EVAR) is used with caution in patients with chronic kidney disease. Contrast-enhanced ultrasound (CEUS) imaging using nonnephrotoxic sulphur hexafluoride microbubble contrast is a novel imaging modality that accurately identifies and characterizes endoleaks during EVAR follow-up. We report our initial experience of using three-dimensional (3D) CEUS imaging intraoperatively as completion imaging after endograft deployment...
December 2014: Journal of Vascular Surgery
Ali Alsafi, Colin D Bicknell, Nung Rudarakanchana, Elika Kashef, Richard G Gibbs, Nicholas J Cheshire, Michael P Jenkins, Mohamad Hamady
BACKGROUND: The suitability of the proximal landing zone remains one of the main limitations to thoracic endovascular aortic repair (TEVAR). The advent of custom-made scalloped stent grafts widens the endovascular options for patients with challenging anatomy. The objective of this study was to present our early and midterm results of custom-made scalloped thoracic stent grafts. METHODS: Prospectively acquired data relating to patient demographics, procedure details, clinical outcome, and complications were analyzed...
December 2014: Journal of Vascular Surgery
K Oikonomou, R Kopp, A Katsargyris, K Pfister, E L Verhoeven, P Kasprzak
OBJECTIVES: Fenestrated/branched thoracic endovascular repair (F/Br-TEVAR) is increasingly applied for atherosclerotic thoracoabdominal aortic aneurysm (TAAA); however, use in post-dissection TAAAs is still very limited. Experience with F/Br-TEVAR in the treatment of post-dissection TAAA is presented. METHODS: Data were analysed from prospectively maintained databases including all patients with post-dissection TAAAs that underwent F/Br-TEVAR within the period January 2010 to July 2013 in two vascular institutions...
December 2014: European Journal of Vascular and Endovascular Surgery
Theodosios Bisdas, Kristin Weiss, Konstantinos P Donas, Arne Schwindt, Giovanni Torsello, Martin Austermann
PURPOSE: To assess the feasibility and midterm outcomes of iliac branch devices (IBD) for the treatment of aneurysmal distal seal zones after endovascular aneurysm repair (EVAR). METHODS: Between January 2005 and January 2014, 188 patients with aortic aneurysms involving the iliac bifurcation underwent IBD implantation; of these, 18 consecutive patients (17 men; mean age 70±10 years) were treated for aneurysmal degeneration of 22 distal seal zones (mean 36±6-mm diameter) after EVAR...
August 2014: Journal of Endovascular Therapy
Konstantinos P Donas, Giovanni Torsello, Theodosios Bisdas, Martin Austermann, Konstantinos Stavroulakis, Georgios A Pitoulias
PURPOSE: To report a novel indication for the use of chimney grafts to preserve flow to the inferior mesenteric artery (IMA) in patients undergoing endovascular aneurysm repair (EVAR) for aortobi-iliac aneurysms with coexistent bilateral occlusion of the internal iliac arteries (IIA). TECHNIQUE: Via a cutdown over the left axillary artery, a 5-F vertebral catheter was delivered over a conventional 0.035-inch hydrophilic guidewire to selectively catheterize the IMA via a 7-F shuttle sheath, which was then advanced at least 2 cm into the target vessel...
August 2014: Journal of Endovascular Therapy
Giovanni Torsello, Dierk Scheinert, Jan S Brunkwall, Roberto Chiesa, Gioachino Coppi, Carlo Pratesi
OBJECTIVE: This study evaluated the 2-year safety and effectiveness of the European First-in-Human INNOVATION trial for the INCRAFT AAA Stent Graft system (Cordis Corp, Bridgewater, NJ), an ultra-low-profile device for the treatment of abdominal aortic aneurysms. METHODS: From March 2010 to June 2011, the INNOVATION prospective multicenter trial involving six centers in Europe enrolled and treated 60 asymptomatic patients (95% male; mean age, 74.4 ± 6.9 years) with the INCRAFT System...
January 2015: Journal of Vascular Surgery
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