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infrarenal abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28943483/permanent-decline-of-renal-function-after-infrarenal-abdominal-aortic-aneurysm-repair-frequency-and-risk-factors
#1
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Andreas Kribben, Stefan Herget-Rosenthal
BACKGROUND: Permanent renal function decline, development and deterioration of chronic kidney disease (CKD) are associated with serious complications. How frequent is renal function decline after infrarenal abdominal aortic aneurysm (iAAA) repair according to current definitions and what are its risk factors, especially potentially modifiable ones? METHODS: Retrospective observational study including all patients with elective or urgent iAAA repair from 2007 to 2011...
September 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28943011/early-reintervention-after-open-and-endovascular-abdominal-aortic-aneurysm-repair-is-associated-with-high-mortality
#2
Sarah E Deery, Thomas F X O'Donnell, Thomas C F Bodewes, Barbara A Dalebout, Alexander B Pothof, Katie E Shean, Jeremy D Darling, Marc L Schermerhorn
OBJECTIVE: Although reinterventions are generally considered more common after endovascular aneurysm repair (EVAR) than after open surgical repair (OSR), less is known about reintervention in the early postoperative period. Furthermore, there are few data regarding the impact of early reintervention on 30-day mortality. We sought to evaluate the rates and types of reintervention after abdominal aortic aneurysm (AAA) repair and the impact of reintervention on postoperative mortality. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) was queried from 2012 to 2014 for all intact, infrarenal AAA repairs...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28935757/resveratrol-inhibits-growth-of-experimental-abdominal-aortic-aneurysm-associated-with-upregulation-of-angiotensin-converting-enzyme-2
#3
Corey S Moran, Erik Biros, Smriti M Krishna, Yutang Wang, Chris Tikellis, Joseph V Moxon, Mark E Cooper, Paul E Norman, Louise M Burrell, Merlin C Thomas, Jonathan Golledge
OBJECTIVE: Recent evidence suggests an important role for angiotensin-converting enzyme 2 (ACE2) in limiting abdominal aortic aneurysm (AAA). This study examined the effect of ACE2 deficiency on AAA development and the efficacy of resveratrol to upregulate ACE2 in experimental AAA. APPROACH AND RESULTS: Ace2 deletion in apolipoprotein-deficient mice (ApoE(-/)(-)Ace2(-/y) ) resulted in increased aortic diameter and spontaneous aneurysm of the suprarenal aorta associated with increased expression of inflammation and proteolytic enzyme markers...
September 21, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28928956/a-primer-on-infrarenal-abdominal-aortic-aneurysms
#4
REVIEW
Norman R Hertzer
Ruptured abdominal aortic aneurysms have an alarmingly high mortality rate that often exceeds 50%, even when patients survive long enough to be transported to hospitals. Historical data have shown that ruptures are especially likely to occur with aneurysms measuring ≥6 cm in diameter, but there are so many exceptions to this that several randomized clinical trials have been done in an attempt to determine whether smaller aneurysms should be repaired electively as soon as they are discovered. More recently, further trials have been conducted in order to compare the relative benefits and disadvantages of modern endovascular aneurysm repair to those of traditional open surgery...
2017: F1000Research
https://www.readbyqxmd.com/read/28893490/partial-renal-coverage-in-endovascular-aneurysm-repair-causes-unfavorable-renal-flow-patterns-in-an-infrarenal-aneurysm-model
#5
Lennart van de Velde, Esmé J Donselaar, Erik Groot Jebbink, Johannes T Boersen, Guillaume P R Lajoinie, Jean-Paul P M de Vries, Clark J Zeebregts, Michel Versluis, Michel M P J Reijnen
OBJECTIVE: To achieve an optimal sealing zone during endovascular aneurysm repair, the intended positioning of the proximal end of the endograft fabric should be as close as possible to the most caudal edge of the renal arteries. Some endografts exhibit a small offset between the radiopaque markers and the proximal fabric edge. Unintended partial renal artery coverage may thus occur. This study investigated the consequences of partial coverage on renal flow patterns and wall shear stress (WSS)...
September 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28890065/comparison-of-endovascular-stent-grafts-for-abdominal-aortic-aneurysm-repair-in-medicare-beneficiaries
#6
Dominique B Buck, Peter A Soden, Sarah E Deery, Sara L Zettervall, Klaas H J Ultee, Bruce E Landon, A James O'Malley, Marc L Schermerhorn
BACKGROUND: Increased renal complications have been suggested with suprarenal stent grafts, but long-term analyses have been limited. Therefore, the purpose of this study was to evaluate the effect of endograft choice on perioperative and long-term outcomes. METHODS: We compared Medicare beneficiaries undergoing endovascular AAA repair from 2005-2008 with endografts with infrarenal fixation and a single docking limb (AneuRx, Excluder) to those with suprarenal fixation and two docking limbs (Zenith), or a unibody configuration (Powerlink)...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887255/forced-air-warming-in-patients-undergoing-endovascular-procedures-comparison-between-two-thermal-blanket-models
#7
Frederico L J Monteiro, Helio Halpern, Fernando Bortoli, Lucia Kataoka, Cristina Marumo, Mariângela Ribeiro, Matheus Castellassi, Cynthia Mendes, Nelson Wolosker
STUDY OBJECTIVE: The purpose of this study was to compare the efficiency between two thermal blanket models: the upper blanket and the underbody blanket in patient heating and hypothermia prevention during endovascular surgery. DESIGN: Prospective randomized study SETTING: Operating room PATIENTS: 50 patients, ASA 2-4 physical status, receiving endovascular surgery repair of infrarenal abdominal aortic aneurysm or lower limb angioplasty by endovascular technique were studied...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28882515/how-quickly-do-asymptomatic-infrarenal-abdominal-aortic-aneurysms-grow-and-what-factors-affect-aneurysm-growth-rates-analysis-of-a-single-centre-surveillance-cohort-database
#8
Mehtab Ahmad, Rakesh Mistry, James Hodson, Andrew W Bradbury
OBJECTIVE/BACKGROUND: Abdominal aortic aneurysm (AAA) maximum antero-posterior diameter (MAPD) is the parameter most commonly used to inform the timing of surgical intervention. However, other factors, such as growth rates and patient comorbidities are likely to be important considerations as they may influence AAA related complications including rupture, operative outcomes, and the clinical and cost effectiveness of continued surveillance. METHODS: This was a retrospective analysis of a 20 year period of a single centre AAA surveillance database...
September 4, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28876597/radiation-exposure-during-infrarenal-endovascular-aortic-aneurysm-repair
#9
A Ahmed, A Badawy, A Chaudhuri
BACKGROUND: Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms exposes patients and healthcare professions to the deterministic and stochastic effects of ionization radiation. The study aim was to determine our standard of radiation exposure in infrarenal EVARs and compare it against other published data and national guidelines. METHOD: A retrospective analysis of a prospectively collected database of patients undergoing EVARs was obtained. Radiation dose, fluoroscopy time, aneurysm size and patient characteristics were collected...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28856333/acute-global-testicular-infarction-post-evar-from-cholesterol-embolisation-can-be-mistaken-for-torsion
#10
T Pathmarajah, M Abdelhamid, A S Tenna, D J W Paton, J A Hockley, S Jansen
INTRODUCTION: Endovascular aneurysm repair (EVAR) is the most commonly used approach for treatment of abdominal aortic aneurysms (AAA). Testicular infarction is a rare complication of EVAR. A novel case of acute global testicular infarction post-EVAR from cholesterol embolisation mimicking torsion is presented. REPORT: A 75 year old man developed acute right testicular ischaemia requiring orchidectomy following EVAR of an infrarenal aortic aneurysm. The patient was initially diagnosed with testicular torsion as the aetiology of the infarction; however, on re-analysis of histopathology it was found to be secondary to cholesterol emboli...
2017: EJVES Short Rep
https://www.readbyqxmd.com/read/28819822/endovascular-aneurysm-repair-with-balloon-thrombectomy-for-acute-thrombosis-of-abdominal-aortic-aneurysm
#11
Kensuke Uotani, Akihiro Hamanaka, Keigo Matsushiro, Erika Idaka, Kiyo Ito, Yuko Yamasaki, Takeyuki Kushima, Takaki Sugimoto, Koji Sugimoto
Acute occlusion of abdominal aortic aneurysm (AAA) is a rare complication and is usually treated with surgical reconstruction. We present a case of acute AAA occlusion that was successfully treated by endovascular aneurysm repair (EVAR) with Fogarty balloon thrombectomy. A 77-year-old man with a history of acute myocardial ischemia presented with limb weakness and coldness. Contrast-enhanced computed tomography showed a 42-mm-diameter infrarenal AAA that was completely thrombosed in the distal portion. The proximal neck of the aneurysm was patent, and its shape was suitable for EVAR...
August 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28818667/endoconduits-with-pave-and-crack-technique-avoid-open-ilio-femoral-conduits-with-sustainable-mid-term-results
#12
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
October 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28814172/novel-endovascular-management-of-proximal-type-a-debakey-ii-aortic-dissection-with-a-patent-foramen-ovale-occluder
#13
Xun Yuan, Andreas Mitsis, David Mozalbat, Christoph A Nienaber
PURPOSE: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). CASE REPORT: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28795036/delayed-type-iii-endoleak-caused-by-fabric-erosion-after-endovascular-repair-of-an-abdominal-aortic-aneurysm
#14
Jae Hang Lee, Eung-Joong Kim, Jin-Ho Choi
A 74-year-old patient presented with recurrent aneurysms in the infrarenal abdominal aorta and right common iliac artery 6 years after endovascular aortic repair using endografts in the same location. The patient underwent an aorto-bi-iliac replacement with removal of the stent graft. Two holes measuring 2 mm each were found in the removed graft, and they appeared to have been caused by wear from continuous friction between the endograft and the aortic wall.
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28782417/improving-patient-compliance-with-post-evar-surveillance-may-prevent-late-rupture
#15
Alicia L Skervin, Chung S Lim, Kaji Sritharan
Endovascular aneurysm repair (EVAR) has gained increasing popularity in the treatment of infrarenal abdominal aortic aneurysm. Despite its favorable early outcomes, the long-term efficacy of EVAR remains a concern. Late rupture is the ultimate treatment failure and continues to complicate EVAR. Univariate and multivariate analyses have identified factors predictive of late rupture. The importance of EVAR surveillance to prevent late complications is equally widely acknowledged. This article aims to present our current understanding of the precipitating factors of late rupture after EVAR and explores whether the key to its prevention lies within improving patient factors, particularly compliance to follow-up appointments or whether physicians hold the solution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28782415/no-difference-in-neck-enlargement-for-patients-treated-with-double-proximal-self-expandable-suprarenal-fixation-endografting
#16
Andrés Reyes Valdivia, Georgios Pitoulias, África Duque Santos, Martín Fabregate Fuente, Apostolos G Pitoulias, Julia Ocaña Guaita, Claudio Gandarias
INTRODUCTION: Neck enlargement is well described in patients treated with self-expandable endografts for abdominal aortic aneurysms. Double endografting (ie, overlapping of stent grafts) occurs in patients with proximal cuffs or bifurcated to monoiliacal configuration conversions. When the aortic neck of patients receives 2 suprarenal fixation endografts, it may behave differently in terms of radial force and interaction of additional suprarenal stents extending to the visceral aorta...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28779856/editor-s-choice-renal-complications-after-evar-with-suprarenal-versus-infrarenal-fixation-among-all-users-and-routine-users
#17
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
https://www.readbyqxmd.com/read/28765014/follow-up-on-small-abdominal-aortic-aneurysms-using-three-dimensional-ultrasound-volume-versus-diameter
#18
Q M Ghulam, K K Bredahl, L Lönn, L Rouet, H H Sillesen, J P Eiberg
OBJECTIVES: Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. DESIGN: This was a prospective cohort study with repeated diameter and volume measurements by 3D-US...
October 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28721336/post-endovascular-aneurysm-repair-evar-testicular-ischemia-a-rare-complication
#19
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
#20
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
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