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endovascular aortic repair

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https://www.readbyqxmd.com/read/28221665/totally-percutaneous-versus-surgical-cut-down-femoral-artery-access-for-elective-bifurcated-abdominal-endovascular-aneurysm-repair
#1
REVIEW
Madelaine Gimzewska, Alexander Ir Jackson, Su Ern Yeoh, Mike Clarke
BACKGROUND: Abdominal aortic aneurysms (AAAs) are a vascular condition with significant risk attached, particularly if they rupture. It is, therefore, critical to identify and repair these as an elective procedure before they rupture and require emergency surgery. Repair has traditionally been an open surgical technique that required a large incision across the abdomen. Endovascular abdominal aortic aneurysm repairs (EVARs) are now a common alternative. In this procedure, the common femoral artery is exposed via a cut-down approach and a graft introduced to the aneurysm in this way...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28219557/total-endovascular-repair-of-post-dissection-aortic-arch-aneurysm-with-chimney-technique
#2
Wei-Tao Liang, Su Wang, Jian Zhou, Chen-Jun Han, Qiang Liu, Xiao-Yun Wu, Wang-Fu Zang
Open surgery remains the standard procedure for treatment of aortic arch pathologies. However, total endovascular repair can be a safe option for patients who are poor candidates for surgery because of compromised physiology. We report the case of a 63-year-old man with a post-dissection aortic arch aneurysm. We repaired the aneurysm using thoracic endovascular aortic repair (TEVAR) and used the chimney technique to reconstruct the supra-aortic branches. The patient is doing well after 12-month follow-up, demonstrating that TEVAR with the chimney technique can be used successfully for the treatment of post-dissection arch aneurysm...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216366/implications-of-concomitant-hypogastric-artery-embolization-with-endovascular-repair-of-infrarenal-abdominal-aortic-aneurysms
#3
Behzad S Farivar, Richa Kalsi, Charles B Drucker, Carly B Goldstein, Rajabrata Sarkar, Shahab Toursavadkohi
OBJECTIVE: Hypogastric artery embolization (HAE) is associated with significant risk of ischemic complications. We assessed the impact of HAE on 30-day outcomes of endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2014 to identify and to compare clinical features, operative details, and 30-day outcomes of EVAR with those of concomitant HAE with EVAR (HAE + EVAR)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216363/durable-outcomes-of-thoracic-endovascular-aortic-repair-with-zenith-tx1-and-tx2-devices
#4
Jocelyn M Beach, Yuki Kuramochi, Corey Brier, Eric E Roselli, Matthew J Eagleton
OBJECTIVE: Long-term data regarding the safety and durability of thoracic endovascular aortic repair (TEVAR) are limited. The study objective was to evaluate the long-term outcomes of TEVAR in high-risk patients with descending thoracic aortic pathology. METHODS: High-risk patients were treated with thoracic endografts (2001-2011) under a prospective, physician-sponsored, investigational device exemption trial. Three-dimensional reconstructions and measurements were performed on computed tomography scans acquired before discharge, at 1, 6, and 12 months, and then yearly thereafter...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216360/the-influence-of-prototype-testing-in-three-dimensional-aortic-models-on-fenestrated-endograft-design
#5
Fadi Taher, Juergen Falkensammer, Jamie McCarte, Johann Strassegger, Miriam Uhlmann, Philipp Schuch, Afshin Assadian
OBJECTIVE: The fenestrated Anaconda endograft (Vascutek/Terumo, Inchinnan, UK) is intended for the treatment of abdominal aortic aneurysms with an insufficient infrarenal landing zone. The endografts are custom-made with use of high-resolution, 1-mm-slice computed tomography angiography images. For every case, a nonsterile prototype and a three-dimensional (3D) model of the patient's aorta are constructed to allow the engineers as well as the physician to test-implant the device and to review the fit of the graft...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216359/fenestrated-endovascular-aneurysm-repair-among-octogenarians-at-high-and-standard-risk-for-open-repair
#6
David E Timaran, Martyn Knowles, Tarik Ali, Carlos H Timaran
BACKGROUND: Octogenarians with complex abdominal aortic aneurysms are at higher risk of death and morbidity after open repair. Fenestrated endovascular aneurysm repair (FEVAR) is an alternative to open repair for high-risk patients, such as octogenarians. The aim of this study was to evaluate perioperative and midterm outcomes of FEVAR among octogenarians at high and standard risk for open repair. METHODS: During a 2-year period, 85 patients (68 men [78%] and 17 women [22%]) underwent FEVAR using Zenith (Cook Medical, Bloomington, Ind) Fenestrated AAA Endovascular Grafts (70%), Zenith p-Branch (7%), and fenestrated custom-made devices (22%)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#7
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216355/innovative-postmarket-device-evaluation-using-a-quality-registry-to-monitor-thoracic-endovascular-aortic-repair-in-the-treatment-of-aortic-dissection
#8
Adam W Beck, Joseph V Lombardi, Dorothy B Abel, J Pablo Morales, Danica Marinac-Dabic, Grace Wang, Ali Azizzadeh, John Kern, Mark Fillinger, Rodney White, Jack L Cronenwett, Richard P Cambria
OBJECTIVE: United States Food and Drug Administration (FDA)-mandated postapproval studies have long been a mainstay of the continued evaluation of high-risk medical devices after initial marketing approval; however, these studies often present challenges related to patient/physician recruitment and retention. Retrospective single-center studies also do not fully represent the spectrum of real-world performance nor are they likely to have a sufficiently large enough sample size to detect important signals...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216354/outcomes-of-endovascular-and-open-surgical-repair-of-ruptured-abdominal-aortic-aneurysms-in-elderly-patients
#9
Tze-Woei Tan, Mohammad Eslami, Denis Rybin, Gheorghe Doros, Wayne W Zhang, Alik Farber
BACKGROUND: Endovascular aneurysm repair (EVAR) is becoming the preferred treatment modality for patients with a ruptured abdominal aortic aneurysm (rAAA). Although the survival advantage of EVAR over open aortic repair (OAR) has been shown in some studies, it is unclear whether this benefit extends to elderly patients. We sought to evaluate the outcomes of rAAA repair in octogenarians. METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data set (2005-2014) to identify patients older than 80 years who were treated with EVAR and OAR for rAAA...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216353/left-subclavian-artery-revascularization-in-zone-2-thoracic-endovascular-aortic-repair-is-associated-with-lower-stroke-risk-across-all-aortic-diseases
#10
Rhiannon J Bradshaw, S Sadie Ahanchi, Obie Powell, Sebastian Larion, Colin Brandt, Michael C Soult, Jean M Panneton
BACKGROUND: The best management strategy for the left subclavian artery (LSA) in pathologic processes of the aorta requiring zone 2 thoracic endovascular aortic repair (TEVAR) remains controversial. We compared LSA coverage with or without revascularization as well as the different means of LSA revascularization. METHODS: A retrospective chart review was conducted of patients with any aortic diseases who underwent zone 2 TEVAR deployment from 2007 to 2014. Primary end points included 30-day stroke and 30-day spinal cord injury (SCI)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216352/outcome-of-endovascular-repair-for-intact-and-ruptured-thoracic-aortic-aneurysms
#11
Tina Hellgren, Anders Wanhainen, Johnny Steuer, Kevin Mani
OBJECTIVE: The objective of this study was to assess long-term outcome after thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysm (TAA). METHODS: All patients who underwent TEVAR for TAA at Uppsala University Hospital from December 1999 to December 2014 were included. Characteristics of the patients and outcome data were collected from medical records, national population registry, and cause of death registry. Perioperative survival was analyzed with the χ(2) test, and 5-year survival was estimated with Kaplan-Meier analysis...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216351/the-fate-of-endovascular-aortic-aneurysm-repair-after-5%C3%A2-years-monitored-with-duplex-ultrasound-imaging
#12
Danielle M Pineda, Zachary M Phillips, Keith D Calligaro, Emilia Krol, Matthew J Dougherty, Douglas A Troutman, Alan Dietzek
BACKGROUND: Interventions for aortic aneurysm sac growth have been reported across multiple time points after endovascular aortic aneurysm repair (EVAR). We report the long-term outcomes of patients after EVAR monitored with duplex ultrasound (DUS) imaging with respect to the need for and type of intervention after 5 years. METHODS: We report a series of patients who were monitored with DUS imaging for a minimum of 5 years after EVAR. DUS imaging was performed in an accredited noninvasive vascular laboratory, and computed tomography angiography was only performed for abnormal DUS findings...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216350/application-of-color-coded-quantitative-digital-subtraction-angiography-in-predicting-the-outcomes-of-immediate-type-i-and-type-iii-endoleaks
#13
Min Zhou, Zijie Su, Zhenyu Shi, Weiguo Fu, Xiangdong Meng, Yonggang Wang, Baolei Guo, Kaiyi Huang
OBJECTIVE: Immediate type I and type III endoleaks after endovascular aneurysm repair (EVAR) could be persistent or temporary. Reintervention is necessary for persistent ones. Color-coded quantitative digital subtraction angiography (CQDSA) could provide a quantitative evaluation of the endoleak hemodynamics. We aimed to use CQDSA to quantify immediate type I and type III endoleaks after EVAR and to find a practical way to predict their outcomes. METHODS: Between January 2012 and December 2014, 485 consecutive patients with abdominal aortic aneurysms underwent EVAR at our institution...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216349/preoperative-hypoalbuminemia-is-associated-with-poor-clinical-outcomes-after-open-and-endovascular-abdominal-aortic-aneurysm-repair
#14
Elica Inagaki, Alik Farber, Mohammad H Eslami, Jeffrey Kalish, Denis V Rybin, Gheorghe Doros, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: The effect of preoperative malnutrition on outcomes in patients undergoing major vascular surgery is unclear. We investigated the effects of preoperative hypoalbuminemia, a marker for malnutrition, on outcomes after open abdominal aortic aneurysm repair (OAR) and endovascular abdominal aortic aneurysm repair (EVAR). METHODS: Patients undergoing OAR or EVAR were identified in the 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program database and stratified into three groups: normal albumin (serum albumin >3...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216346/evaluation-of-visible-spinal-arteries-on-computed-tomography-angiography-before-and-after-branched-stent%C3%A2-graft-repair-for-thoracoabdominal-aortic-aneurysm
#15
Konstantinos Gallis, Piotr M Kasprzak, Beatrix Cucuruz, Reinhard Kopp
OBJECTIVE: The aim of this study was to evaluate the impact of intercostal and lumbar segmental arteries (SAs) detectable on computed tomography angiography (CTA) on the risk of spinal cord ischemia (SCI) in patients undergoing single-step or two-staged branched endovascular aneurysm repair (BEVAR). METHODS: A retrospective analysis of patients treated with branched stent grafts for thoracoabdominal aortic aneurysm at a single institution from January 2009 to June 2015 was performed...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216344/perioperative-outcome-of-endovascular-repair-for-complex-abdominal-aortic-aneurysms
#16
Klaas H J Ultee, Sara L Zettervall, Peter A Soden, Jeremy Darling, Hence J M Verhagen, Marc L Schermerhorn
BACKGROUND: As endovascular aneurysm repair (EVAR) continues to advance, eligibility of patients with anatomically complex abdominal aortic aneurysms (AAAs) for EVAR is increasing. However, whether complex EVAR is associated with favorable outcome over conventional open repair and how outcomes compare with infrarenal EVAR remains unclear. This study examined perioperative outcomes of patients undergoing complex EVAR, focusing on differences with complex open repair and standard infrarenal EVAR...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215108/antithrombotic-therapy-in-aortic-diseases-a-narrative-review
#17
Francois Caron, Sonia S Anand
Aortic diseases are a heterogeneous group of disorders, including atherothrombotic conditions like aortic atheroma, cholesterol embolization syndrome, aortic mural thrombus, thrombus within an aneurysm, and large vessel vasculitis. In this review, we provide a summary of the current evidence regarding atherothrombotic diseases of the aorta, focusing on therapeutic avenues. In patients with previous stroke, aortic arch atheroma is recognized as a strong predictor of recurrent atheroembolism, and antiplatelet therapy alone is still associated with a high (11...
February 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28215061/innovation-four-year-safety-and-effectiveness-of-the-incraft%C3%A2-aaa-stent-graft-for-endovascular-repair-of-abdominal-aortic-aneurysms
#18
Giovanni Pratesi, Carlo Pratesi, Roberto Chiesa, Gioacchino Coppi, Dierk Scheinert, Jan S Brunkwall, Stefaan Van der Meulen, Giovanni Torsello
BACKGROUND: This paper reports the 4-year safety and effectiveness of the INCRAFT® AAA Stent Graft system (Cordis Corp, Milpitas, CA), an ultra-low-profile device for the treatment of abdominal aortic aneurysms. METHODS: The INNOVATION Trial is the prospective, first-in-human, multicenter trial to evaluate the safety and effectiveness of the INCRAFT® System. Patients underwent annual clinical and CTA examination as part of the study protocol. The INCRAFT® AAA Stent Graft System is a customizable tri-modular design, with an ultra-low profile (14Fr) delivery system...
February 17, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28214128/robotic-arch-catheter-placement-reduces-cerebral-embolization-during-thoracic-endovascular-aortic-repair-tevar
#19
A H Perera, C V Riga, L Monzon, R G Gibbs, C D Bicknell, M Hamady
OBJECTIVE: Stroke caused by cerebral embolization constitutes a principal risk during arch manipulation and thoracic endovascular aortic repair (TEVAR). This study investigates the incidence of cerebral embolization during catheter placement in the aortic arch, and compares robotic and manual techniques. METHODS: Intra-operative transcranial Doppler (TCD) was performed in 11 patients undergoing TEVAR. Wire and catheter placement in the arch was performed by two experienced operators...
February 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28207510/endovascular-repair-of-bilateral-common-iliac-artery-aneurysms-using-gore-excluder-iliac-branch-endoprosthesis-without-aortobi-iliac-stent-graft-conjunction-a-case-report
#20
Vincenzo Ardita, Alessia Giaquinta, Massimiliano Veroux, Angelo Sanfiorenzo, Carla Virgilio, Giuseppe D'Arrigo, Pierfrancesco Veroux
INTRODUCTION: Bilateral common iliac artery (CIA) aneurysm (CIAA) is a rare entity. In the past decade, different endovascular approaches have been adopted for patients with several comorbidities or unfit for open repair (OR). Recently, the use of iliac branch stent graft has been proposed, resulting in satisfactory patency rates and decrease in morbidity. Currently, according to instruction for use, the iliac branch stent graft is to be used with aortobi-iliac stent graft conjunction...
February 2017: Medicine (Baltimore)
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