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infrarenal abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28073666/standard-endovascular-aneurysm-repair-in-patients-with-wide-infrarenal-aneurysm-necks-is-associated-with-increased-risk-of-adverse-events
#1
Nelson F G Oliveira, Frederico M Bastos Gonçalves, Marie Josee Van Rijn, Quirina de Ruiter, Sanne Hoeks, Jean-Paul P M de Vries, Joost A van Herwaarden, Hence J M Verhagen
OBJECTIVE: Endovascular aneurysm repair (EVAR) has progressively expanded to treat more challenging anatomies. Although EVAR in patients with wide infrarenal necks has been reported with acceptable results, there is still controversy regarding the longer-term outcomes. Our aim is to determine the impact of infrarenal neck diameter on midterm outcome following EVAR with a single endograft with suprarenal fixation. METHODS: A retrospective case-control study was designed using data from a prospective multicenter database...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28058986/midterm-results-of-proximal-aneurysm-sealing-with-the-ovation-stent-graft-according-to-on-vs-off-label-use
#2
Gianmarco de Donato, Francesco Setacci, Luciano Bresadola, Patrizio Castelli, Roberto Chiesa, Nicola Mangialardi, Giovanni Nano, Carlo Setacci
PURPOSE: To compare the use of the Ovation stent-graft according to the ≥7-mm neck length specified by the original instructions for use (IFU) vs those treated off-label (OL) for necks <7 mm long. METHODS: A multicenter retrospective registry (TriVascular Ovation Italian Study) database of all patients who underwent endovascular aneurysm repair with the Ovation endograft at 13 centers in Italy was interrogated to identify patients with a minimum computed tomography (CT) follow-up of 24 months, retrieving records on 89 patients (mean age 76...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28042554/chronological-change-of-the-sac-after-endovascular-aneurysm-repair
#3
Min Hyun Kim, Hyung Sub Park, Sanghyun Ahn, Sang-Il Min, Seung-Kee Min, Jongwon Ha, Taeseung Lee
PURPOSE: The purpose of this study was to evaluate the potential risk factors of type II endoleak and sac growth after endovascular aneurysm repair (EVAR) and the outcomes of secondary interventions. MATERIALS AND METHODS: Ninety seven patients underwent elective EVAR for infrarenal abdominal aortic aneurysms in two tertiary centers between April 2005 and July 2013. Clinical and imaging parameters were compared among sac growth (>5 mm) and non-growth groups. Risk factors associated with sac growth and persistent type II endoleak were analyzed...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/28034703/hybrid-treatment-expanding-the-armamentarium-for-infected-infrarenal-abdominal-aortic-and-iliac-aneurysms
#4
Kichang Han, Do Yun Lee, Man-Deuk Kim, Sak Lee, Jong Yun Won, Joon Ho Kwon, Donghoon Choi, Young-Guk Ko
PURPOSE: To investigate safety and efficacy of hybrid treatment for infected aortic and iliac aneurysms. MATERIALS AND METHODS: Between July 2007 and May 2011, hybrid treatment was performed in 6 male patients (mean age, 67.7 y; range, 57-76 y). Hybrid treatment consisted of extraanatomic bypass (EAB) and isolation of infected aneurysm with vascular plugs. Aneurysms were divided into primary and secondary infected aneurysms. Primary infected aneurysm refers to an aneurysm arising from bacterial infection of the native arterial wall; secondary infected aneurysm refers to infection involving an aneurysm that was previously treated with graft placement...
December 26, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28031677/durable-results-with-in-situ-graft-repair-of-ruptured-salmonella-aneurysm-in-a-patient-with-autoimmune-deficiency-syndrome
#5
Patrick C Thompson, Lisa Wang, Jesse Columbo, Andres Schanzer, William P Robinson
We describe a case of a 42-year-old male patient with advanced autoimmune deficiency syndrome (AIDS) (CD4 count of 16 cells/mm(3)) found to have a ruptured infected infrarenal aortic aneurysm. Emergent in situ repair was performed with a Hemashield Dacron graft (Boston Scientific, Natick, MA). Aortic tissue cultures grew group D Salmonella. Patient was placed initially on intravenous ciprofloxacin followed by lifelong oral levofloxacin and trimethoprim. Over 2 years following repair, he remains asymptomatic, with repair intact and no recurrent infection...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031651/spontaneous-retroperitoneal-hematoma-simulating-ruptured-infrarenal-aortic-aneurysm-in-a-patient-with-end-stage-renal-disease
#6
Jyy Li, Y C Chan, K X Qing, S W Cheng
We reported a case of spontaneous retroperitoneal hematoma (SRH) simulating a ruptured infrarenal aortic aneurysm. A 72-year-old man with a history of infrarenal aortic aneurysm and end-stage renal disease on hemodialysis presented with malaise and nonspecific central abdominal pain and left loin discomfort. An emergency computed tomography scan showed a large retroperitoneal hematoma and clinical suspicion of ruptured infrarenal aortic aneurysm. However, the hematoma was discontinuous with the aneurysm sac and raised the clinical suspicion on dual pathology...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029566/midterm-results-of-the-fenestrated-anaconda-endograft-for-short-neck-infrarenal-and-juxtarenal-abdominal-aortic-aneurysm-repair
#7
Louise L Blankensteijn, Martijn L Dijkstra, Ignace F J Tielliu, Michel M P J Reijnen, Clark J Zeebregts
OBJECTIVE: The fenestrated Anaconda endograft (Vascutek, Renfrewshire, Scotland) was introduced in 2010 and showed promising short-term results with high technical success and low morbidity rates. The aim of this study was to present the midterm results, with a minimum of 12 months follow-up, for all patients treated with the fenestrated Anaconda endograft in The Netherlands. METHODS: Patients treated with the fenestrated Anaconda endograft between May 2011 and February 2015 were included...
October 28, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27993378/aortic-remodeling-after-endovascular-repair-of-complicated-acute-type-b-aortic%C3%A2-dissection
#8
Bradley G Leshnower, Yazan M Duwayri, Edward P Chen, Chun Li, Carl A Zehner, Jose N Binongo, Ravi K Veeraswamy
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is the optimal therapy for complicated acute type B aortic dissection (aTBAD). This study examined clinical outcomes and aortic remodeling parameters after TEVAR for patients with complicated aTBAD. METHODS: From January 2012 to December 2015, 51 patients underwent TEVAR for complicated aTBAD. Preoperative and postoperative imaging studies were analyzed for sizes of the true lumen (TL) and false lumen (FL) and for the FL thrombosis status at five locations in the thoracic and abdominal aorta...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27989317/extended-use-of-endovascular-aneurysm-sealing-chimneys-for-juxtarenal-aneurysms
#9
REVIEW
K M Stenson, J L De Bruin, P J E Holt, I M Loftus, M M Thompson
Hostile infrarenal aortic neck anatomy presents a challenge for the endovascular treatment of abdominal aortic aneurysm. Open surgical repair has been seen as the gold standard treatment for juxtarenal abdominal aortic aneurysm; however, endovascular techniques are now becoming more prevalent, particularly in patients deemed high risk for morbidity and mortality with open repair. The morphology of an aneurysm is a determinant of long-term outcomes, and short aneurysm necks are associated with poorer outcomes and a higher rate of secondary reinterventions...
September 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27989316/treating-iliac-aneurysm-using-the-nellix-endovascular-sac-sealing-system
#10
REVIEW
Marwan Youssef, Sebastian Zerwes, Rudolf Jakob, Fritz Dünschede, Bernhard Dorweiler, Christian F Vahl
As endovascular treatment of abdominal aortic aneurysms has become established, there has been growing focus on treatment of the aneurysmal iliac artery. Isolated, large iliac aneurysms >30 mm pose a risk of rupture, but, in addition, 20% to 30% of abdominal aortic aneurysms are associated with iliac aneurysmal dilatation, which can compromise long-term outcomes. Endovascular solutions are evolving and until recently have utilized standard stent graft technology. The endovascular aortic sealing system was introduced as a new, effective method for the treatment of infrarenal aortic aneurysms...
September 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27986486/one-year-pivotal-trial-outcomes-of-the-nellix-system-for-endovascular-aneurysm-sealing
#11
Jeffrey P Carpenter, Robert Cuff, Clifford Buckley, Christopher Healey, Sajjad Hussain, Michel M P J Reijnen, Jose Trani, Dittmar Böckler
OBJECTIVE: The Nellix EndoVascular Aneurysm Sealing (EVAS) System (Endologix, Inc, Irvine, Calif) is a novel approach to abdominal aortic aneurysm (AAA) treatment whereby polymer is used to fill the AAA sac. We report 1-year results of the investigational device exemption pivotal trial. METHODS: Eligible patients were treated at 30 sites in the United States and Europe. Inclusion criteria required an asymptomatic infrarenal AAA, with a neck length ≥10 mm and ≤60° angle, iliac artery blood lumen diameter 9 to 35 mm, access artery diameter ≥6 mm, and serum creatinine ≤2 mg/dL...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27986483/contemporary-open-repair-of-ruptured-abdominal-aortic-aneurysms
#12
Jeffrey J Siracuse, Brianna M Krafcik, Alik Farber, Jeffrey A Kalish, Andrew McChesney, Denis Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Although endovascular repair of ruptured abdominal aortic aneurysms (rAAAs) is increasingly more prevalent and may yield better results, open repair of rAAAs is still commonly performed. Our goal was to assess the contemporary practice patterns and outcomes of open repair of rAAA. METHODS: The 2011-2014 American College of Surgeons National Surgical Quality Improvement Program targeted open AAA database was queried for all rAAAs. Patient characteristics, presentation, aneurysm details, and operative details were analyzed to identify factors that may affect outcome in this population of patients...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27986477/sex-differences-in-mortality-and-morbidity-following-repair-of-intact-abdominal-aortic-aneurysms
#13
Sarah E Deery, Peter A Soden, Sara L Zettervall, Katie E Shean, Thomas C F Bodewes, Alexander B Pothof, Ruby C Lo, Marc L Schermerhorn
OBJECTIVE: Medicare studies have shown increased perioperative mortality in women compared with men following endovascular and open abdominal aortic aneurysm (AAA) repair. However, a recent regional study of high-volume centers, adjusting for anatomy but limited in sample size, did not show sex to be predictive of worse outcomes. This study aimed to evaluate sex differences after intact AAA repair in a national clinical registry. METHODS: The targeted vascular module of the National Surgical Quality Improvement Program was queried to identify patients undergoing endovascular aneurysm repair (EVAR) or open repair for intact, infrarenal AAA from 2011 to 2014...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27956648/abdominal-aortic-aneurysm-with-renal-arteries-originating-above-the-superior-mesenteric-artery
#14
Ajit Rao, Adam Korayem, Rami Tadros, Peter Faries, Michael Marin, Rajiv Chander
A 63-year-old female presented to clinic following an incidental finding of an abdominal aortic aneurysm (AAA). Preoperative imaging was consistent with an infrarenal AAA over 5-cm in diameter with both renal arteries originating above the superior mesenteric artery (SMA). The patient subsequently underwent an endovascular aneurysm repair (EVAR) using the AFX stent-graft (Endologix, Inc, Irvine, Calif). Notably, the proximal stent-graft piece was unsheathed with the image intensifier in a lateral position to ensure deployment below the SMA...
December 12, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27908810/emergent-treatment-of-a-ruptured-thoraco-abdominal-aortic-aneurysm-by-off-label-rescue-implantation-of-the-ovation-%C3%A2-stent-graft-in-nonagenarians-patient
#15
Chiara Pranteda, Pasqualino Sirignano, Federica Fornelli, Wassim Mansour, Nunzio Montelione, Laura Capoccia, Francesco Speziale
We report a case of a compassionate treatment of a ruptured thoraco-abdominal aortic aneurysm in a 92-year-old patient. Patient was admitted to our emergency department for acute onset of pain irradiating to the back. Computed tomographic angiography showed the presence of a thoraco-abdominal aortic aneurysm with a contained rupture at infrarenal level. Given of the presence of a relative healthy visceral aorta, we decided to treat the patient by Ovation(®) (Endologix, Irvine, CA - USA) implantation in an off-label fashion...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27894897/the-long-term-durability-of-intra-operatively-placed-palmaz-stents-for-the-treatment-of-type-ia-endoleaks-after-evar-of-abdominal-aortic-aneurysm
#16
M Abdulrasak, T Resch, B Sonesson, J Holst, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. METHODS: This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months' follow-up...
November 25, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27894713/abdominal-aortic-aneurysm-in-marfan-syndrome
#17
Tracy Hagerty, Patrick Geraghty, Alan C Braverman
OBJECTIVE: Marfan syndrome (MFS) leads to aortic root aneurysm, while descending thoracic aortic aneurysm (TAA) occurs less commonly. Abdominal aortic aneurysm (AAA) is rarely reported in MFS. Risk factors for AAA are poorly understood and there are no guidelines for AAA screening in MFS. We sought to characterize AAA among Marfan patients in our center. METHODS: The records of 12 adults with MFS and AAA disease were reviewed. Clinical features, imaging, operative reports, and outcomes were analyzed...
November 25, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890835/acute-kidney-injury-after-open-repair-of-intact-abdominal-aortic-aneurysms
#18
REVIEW
Charles Dariane, Raphaël Coscas, Celia Boulitrop, Isabelle Javerliat, Eve Vilaine, Olivier Goeau-Brissonniere, Marc Coggia, Ziad A Massy
BACKGROUND: These last years, considerable attention has been given to renal issues following endovascular aortic repair but acute kidney injury (AKI) also remains one of the most frequent complications following open repair (OR). Since AKI definition has evolved, our aim was to review the etiology, incidence, classifications, and consequences of AKI after OR for intact abdominal aortic aneurysm (AAA). METHODS: A review of the English language literature published between 2004 and 2016 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890833/pulse-wave-analysis-after-treatment-of-abdominal-aortic-aneurysms-with-the-ovation-device
#19
Efstratios Georgakarakos, Christos Argyriou, George S Georgiadis, Miltos K Lazarides
BACKGROUND: Ovation aortic stent-graft system is a new device for the endovascular treatment of Abdominal Aortic Aneurysms achieving fixation via a 35-mm long, rigid anchored suprarenal stent and sealing stent at the infrarenal level by a means of a polymer-filling pair of inflatable O-rings, which cause narrowing of flow lumen and regional stenosis. Thus, concerns have been raised regarding hemodynamic consequences associated with this new design. Our preliminary report showed no significant increase of aortic pulse wave velocity (aPWV) immediately after implantation of the ovation in 3 patients...
November 25, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27887854/significant-regional-variation-exists-in-morbidity-and-mortality-after-repair-of-abdominal-aortic-aneurysm
#20
Sara L Zettervall, Peter A Soden, Dominique B Buck, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs. METHODS: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014. Ruptured and intact aneurysms were evaluated separately, and the analysis of intact aneurysms was limited to infrarenal AAAs...
November 22, 2016: Journal of Vascular Surgery
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