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infrarenal abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28721336/post-endovascular-aneurysm-repair-evar-testicular-ischemia-a-rare-complication
#1
Eric Thomas, Brett L Parra, Shonak Patel
Endovascular aneurysm repair (EVAR) is a common modality of treating abdominal aortic aneurysms (AAA). Common complications include endoleak, bleeding, infection, contrast related injuries, and ischemia. We present the case of a patient who experienced a testicular infarction following repair of an infrarenal AAA. We also discuss the implications for this complication and review the available literature for similar cases and treatment options.
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#2
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28702183/induction-of-autoimmune-abdominal-aortic-aneurysm-in-pigs-a-novel-large-animal-model
#3
Sara Schødt Riber, Mulham Ali, Sara Hveding Bergseth, Jane Stubbe, Michael Stenger, Carsten Behr-Rasmussen, Jes Sanddal Lindholt
BACKGROUND: Abdominal aortic aneurysm (AAA) is a common disease with a high mortality. Many animal models have been developed to further understand the pathogenesis of the disease, but no large animal model has been developed to investigate the autoimmune aspect of AAA formation. The aim of this study was to develop a large animal model for abdominal aortic aneurysm induction through autoimmunity by performing sheep-to-pig xenotransplantation. METHODS: Six pigs underwent a xenotransplantation procedure where the infrarenal porcine aorta was replaced by a decellularized sheep aorta...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28694579/surgical-repair-of-congenital-abdominal-aortic-aneurysm-in-a-1-year-old-child-with-literature-review
#4
Ashwani Bansal, Aparajita Mitra, Akshay Kumar Bisoi, Sandeep Agarwala
Reported here is a case of 1-year-old male child who presented with huge abdominal mass, which on radiological investigation was diagnosed as retroperitoneal pseudoaneurysm of the aorta. On exploration, it was found to be a true aneurysm of infrarenal abdominal aorta with inflow agenesis. Aneurysm was excised, and aorta was reconstructed with 10 mm Dacron graft. Postoperative computed tomography angiography showed patent graft with good distal runoff. Literature review revealed that only 26 cases of congenital abdominal aortic aneurysm had been reported so far...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28690997/endovascular-aneurysm-repair-in-patients-with-conical-neck-anatomy
#5
Jae Hoon Lee, Ki Hyuk Park
PURPOSE: Cone shape neck is regarded as non-instruction for use (IFU) in most commercial stent graft. However, in real practice, liberal application of endovascular aneurysm repair (EVAR) for outside of IFU happens. We investigate non-adherence to conical neck anatomy in terms of early aneurysmal exclusion results. MATERIALS AND METHODS: From January 2010 to December 2013, 105 patients with abdominal aortic aneurysm (AAA) underwent EVAR in Daegu Catholic University Medical Center...
June 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28689483/the-influence-of-positioning-of-the-nellix-endovascular-aneurysm-sealing-system-on-suprarenal-and-renal-flow-an-in-vitro-study
#6
Johannes T Boersen, Erik Groot Jebbink, Lennart Van de Velde, Michel Versluis, Guillaume Lajoinie, Cornelius H Slump, Jean-Paul P M de Vries, Michel M P J Reijnen
PURPOSE: To examine the influence of device positioning and infrarenal neck diameter on flow patterns in the Nellix endovascular aneurysm sealing (EVAS) system. METHODS: The transition of the aortic flow lumen into two 10-mm-diameter stents after EVAS creates a mismatched area. Flow recirculation may affect local wall shear stress (WSS) profiles and residence time associated with atherosclerosis and thrombosis. To examine these issues, 7 abdominal aortic aneurysm flow phantoms were created, including 3 unstented controls and 3 stented models with infrarenal neck diameters of 24, 28, and 32 mm...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28685523/the-role-of-surgeon-modified-fenestrated-stent-grafts-in-the-treatment-of-aneurysms-involving-the-branched-visceral-aorta
#7
Benjamin J Pearce, Salvatore T Scali, Adam W Beck
Acceptance of endovascular technology has followed a predictable pattern in the treatment of aortic aneurysm disease. Initially, endovascular aneurysm repair (EVAR) was used to treat infrarenal abdominal aortic aneurysms (AAA) only in patients deemed medically unsuitable for open surgical repair (OSR). With improvement in device design, increased operative experience and favorable mortality benefits in randomized control trials, EVAR is now the preferred method for treatment of AAA worldwide. As the results with OSR are even worse as one ascends the aorta into the visceral segment and above, it stands to reason that EVAR technology to accommodate the aortic branches should have a similar adoption in treatment of proximal AAA and thoraco-abdominal aortic aneurysm (TAAA) disease...
July 7, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28674268/oral-steroid-use-and-abdominal-aortic-aneurysm-expansion%C3%A3-positive-association
#8
Yuta Tajima, Hitoshi Goto, Masato Ohara, Munetaka Hashimoto, Daijiro Akamatsu, Takuya Shimizu, Noriyuki Miyama, Ken Tsuchida, Keiichiro Kawamura, Michihisa Umetsu, Shunya Suzuki, Noriaki Ohuchi
BACKGROUND: The maximum axial diameter (MAD) of a fusiform abdominal aortic aneurysm (AAA) is an indicator of the risk of expansion or rupture. Apart from smoking and MAD itself, few expansion risk factors have been reported. In this study, we investigated expansion risk factors for AAA.Methods and Results:This retrospective cohort study included 176 patients who attended Tohoku University Hospital with infrarenal fusiform AAA. AAA expansion rate was determined on multidetector computed tomography, and the correlations between expansion rate and the clinical data were analyzed...
June 30, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28619644/management-and-outcomes-of-symptomatic-abdominal-aortic-aneurysms-during-the-past-20%C3%A2-years
#9
Venita Chandra, Karen Trang, Whitt Virgin-Downey, Ken Tran, E John Harris, Ronald L Dalman, Jason T Lee, Matthew W Mell
OBJECTIVE: We compared the management of patients with symptomatic, unruptured abdominal aortic aneurysms (AAAs) treated at a tertiary care center between two decades. This 20-year period encapsulated a shift in surgical approach to aortic aneurysms from primarily open to primarily endovascular, and we sought to determine the effect of this shift in the evaluation, treatment, and clinical outcomes of patients with symptomatic AAA. METHODS: We reviewed 1429 consecutive patients with unruptured AAAs treated at a tertiary care hospital by six staff surgeons between 1995 and 2004 (era 1) and between 2005 and 2014 (era 2)...
June 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28616352/aortic-polyaneurysmal-disease-case-report
#10
Lucas Alvarez García, Paula Vidal Fernández, Miguel Felipe García Gimeno, Miguel Angel González Arranz, Maria Emma González González, Diego López García, Salvador Tagarro Villalba, Santiago Rodríguez Camarero
We report a 78-year-old man who presents progression of his aneurysmatic pathology with previous abdominal infrarenal aortic surgery 20 years later. The computed tomography (CT) scan showed proximal degeneration of the infrarenal aorta, left iliac aneurysm and a new descending thoracic aneurysm close to the aortic arch. The surgical treatment was staged in two times due to the evolution of the aneurysm measures. First, the thoracic and the infrarenal aneurysms were covered each one with endoprosthesis. Four years later the iliac disease was solved with a branched specific iliac endograft...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602623/comparison-of-outcomes-for-short-neck-and-juxtarenal-aortic-aneurysms-treated-with-the-nellix-endograft-versus-conventional-endovascular-aneurysm-sealing
#11
Daniele Psacharopulo, Michelangelo Ferri, Emanuele Ferrero, Sandeep S Bahia, Andrea Viazzo, Alberto Pecchio, Fulvio Ricceri, Franco Nessi
OBJECTIVE: The objective of this study was to evaluate the results of the off-label use of the Nellix endograft (Endologix, Irvine, Calif) for the treatment of short-neck aneurysms and juxtarenal aortic aneurysms (JAAs) compared with the outcomes of patients with infrarenal abdominal aortic aneurysms treated in accordance with the manufacturer's instructions for use. METHODS: Data available from patients treated with the Nellix endograft from September 2013 to January 2016 were reviewed to create a case-control analysis (1:2)...
June 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28602492/open-versus-endovascular-aneurysm-repair-trial-review
#12
Craig Weinkauf, Elizabeth George, Wei Zhou
The Open versus Endovascular Aneurysm Repair trial is the only randomized controlled trial that is funded by the federal government to evaluate the treatment outcomes of infrarenal abdominal aortic aneurysms. Since the initial publication, multiple post-hoc analyses have become available. This review summarizes these data, focusing on the primary outcome measures (ie, overall survival) and several key secondary outcomes including aneurysm-related death, age consideration, secondary procedures, and endoleaks...
June 8, 2017: Surgery
https://www.readbyqxmd.com/read/28597730/early-results-of-the-bolton-treovance-endograft-in-the-treatment-of-abdominal-aortic-aneurysms
#13
Efstratios Georgakarakos, George Pitoulias, Nikolaos Schoretsanitis, Christos Argyriou, Dimitrios M Mavros, Miltos K Lazarides, George S Georgiadis
PURPOSE: To present early results with the Treovance aortic stent-graft in the treatment of abdominal aortic aneurysms (AAAs). METHODS: Between October 2013 and January 2016, 35 consecutive AAA patients (mean age 74±7.7 years; 32 men) were treated with Treovance. The maximum diameter of the treated AAA was 60±9 cm. Nine (25%) patients presented with concomitant iliac aneurysms. Seven (20%) AAAs had infrarenal neck angulation >60°. The infrarenal neck length and diameter were 21...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28594812/-staged-implantation-of-an-abdominal-stent-graft
#14
I V Popova, A A Karpenko, P V Ignatenko, M A Soborov
The article deals with a case report regarding successful surgical management of a patient presenting with an anatomically complicated aneurysm of the aortic infrarenal portion and iliac arteries. The first stage consisted in performing implantation of the Ovation Prime stent graft into the abdominal aorta. One month later, the second stage carried out for residual type IB endoleak consisted in implantation of the iliac components of the stent graft into the external iliac arteries on the right and the left...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28583733/treatment-strategy-based-on-the-natural-course-of-the-disease-for-patients-with-spontaneous-isolated-abdominal-aortic-dissection
#15
Ji-Hee Kang, Young-Wook Kim, Seon-Hee Heo, Shin-Young Woo, Yang-Jin Park, Dong-Ik Kim, Duk-Kyung Kim
OBJECTIVE: This study aimed to determine the natural history of spontaneous isolated abdominal aortic dissection (SIAAD) and to establish an optimal management strategy for patients with SIAAD. METHODS: We searched the database of thoracoabdominal computed tomography (CT) performed at a single institution from January 2003 to July 2016 using the keywords "aortic dissection" and "dissection AND aorta." Once a diagnosis of SIAAD was made, we investigated the initial clinical and morphologic features and aorta-related events for all patients and morphologic changes of the aortic dissection (AD) during the follow-up period for the patients who underwent follow-up CT scans...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28549961/preliminary-results-of-aorfix-tm-stent-graft-to-treat-infrarenal-abdominal-aortic-aneurysms-with-severe-proximal-aortic-neck-angulation
#16
Pietro Volpe, Mafalda Massara, Antonino Alberti, Santo Marino, Alberto Volpe, Daniela Mazzaccaro, Silvia Stegher, Giovanni Nano
BACKGROUND: We report a preliminary experience about endovascular aortic repair (EVAR) of infrarenal abdominal aneurysm (iAAA) with severe proximal aortic neck angulation using the Aorfix(TM) stent graft. METHODS: Data of consecutive patients with iAAA with severe proximal neck angulation submitted to endovascular repair between September 2012 and December 2014 in two Italian centres of Vascular and Endovascular Surgery were retrospectively reviewed and outcomes analyzed using the software JMP 5...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28546041/ten-year-single-center-results-of-abdominal-aortic-aneurysm-treatment-endovascular-versus-open-repair
#17
Payman Majd, Wael Ahmad, Ingrid Becker, Jan Sigge Brunkwall
BACKGROUND: The purpose of the present study was to compare the long-term survival in matched cohorts of patients with infrarenal abdominal aortic aneurysm (AAA) undergoing an elective open repair (OR) or an endovascular aneurysm repair (EVAR). METHODS: Patients with a primary elective repair of an infrarenal aortic aneurysm between 1998 and 2006 were identified in a retrospective review of our single-center database. EVAR and OR patients were matched with respect to age, gender, renal disease, tobacco use, hypertension, chronic obstructive pulmonary disease, and coronary artery disease...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28502552/bifurcated-bifurcated-aneurysm-repair-is-a-novel-technique-to-repair-infrarenal-aortic-aneurysms-in-the-setting-of-iliac-aneurysms
#18
Susanna Hewon Shin, Benjamin Ware Starnes
BACKGROUND: Up to 40% of abdominal aortic aneurysms (AAAs) have coexistent iliac artery aneurysms (IAAs). In the past, successful endovascular repair required internal iliac artery (IIA) embolization, which can lead to pelvic or buttock ischemia. This study describes a technique that uses a readily available solution with a minimally altered off-the-shelf bifurcated graft in the IAA to maintain IIA perfusion. METHODS: From August 2009 to May 2015, 14 patients with AAAs and coexisting IAAs underwent repair with a bifurcated-bifurcated approach...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28484713/quantitative-aortic-distensibility-measurement-using-ct-in-patients-with-abdominal-aortic-aneurysm-reproducibility-and-clinical-relevance
#19
Yunfei Zha, Gongling Peng, Liang Li, Chunying Yang, Xuesong Lu, Zhoufeng Peng
Purpose. To investigate the reproducibility of aortic distensibility (D) measurement using CT and assess its clinical relevance in patients with infrarenal abdominal aortic aneurysm (AAA). Methods. 54 patients with infrarenal abdominal aortic aneurysm were studied to determine their distensibility by using 64-MDCT. Aortic cross-sectional area changes were determined at two positions of the aorta, immediately below the lowest renal artery (level 1.) and at the level of its maximal diameter (level 2.) by semiautomatic segmentation...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28479444/intraoperative-type-iiib-endoleak-after-endograft-deployment-during-evar
#20
Konstantinos G Moulakakis, John D Kakisis, George Geroulakos, Elias N Brountzos
Type IIIb endoleak usually occurs years after the initial endograft implantation, and the cause is the chronic fatigue of the endograft. This rare case describes a type IIIb endoleak, appearing immediately after deployment of a new generation low-profile stentgraft and highlights the diagnostic and treatment challenges associated with the type IIIb endoleak. A 74-year-old man underwent elective EVAR for an infrarenal abdominal aortic aneurysm. A type IIIb endoleak near to the flow divider due to a fabric defect was diagnosed...
May 4, 2017: Annals of Vascular Surgery
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