scholarly journals Adequate seal and no endoleak on the first postoperative computed tomography angiography as criteria for no additional imaging up to 5 years after endovascular aneurysm repair

2013 ◽  
Vol 57 (6) ◽  
pp. 1503-1511 ◽  
Author(s):  
Frederico Bastos Gonçalves ◽  
Koen M. van de Luijtgaarden ◽  
Sanne E. Hoeks ◽  
Johanna M. Hendriks ◽  
Sander ten Raa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Endovascular Aneurysm Repair ◽  
Additional Imaging ◽  
Aneurysm Repair

Evolution and clinical relevance of common iliac artery seal zone after endovascular aortic aneurysm repair

Vascular ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Gergana T Taneva ◽  
Alejandro González García ◽  
Ana Begoña Arribas Díaz ◽  
Yasmina Baquero Yebra ◽  
Konstantinos P Donas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Iliac Artery ◽  
Computed Tomography Angiography ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Stent Grafts ◽  
Iliac Arteries ◽  
Radiological Data ◽  
The Mean ◽  
Aneurysm Repair

Objective Data in literature suggest iliac artery dilatation and endograft retraction as complications after endovascular aneurysm repair. However, mainly older generation endografts were included. Therefore, we sought to evaluate the distal sealing zone chronological changes after endovascular aneurysm repair with newer generation stent-grafts. Methods Clinical and radiological data of patients with abdominal aortic aneurysms treated with endovascular aneurysm repair between January 2010 and December 2013 were reviewed. Measurements were made using volumetric reconstructions in the first and last available computed tomography angiography. Endpoints of the study were the presence of iliac dilatation and retraction of the endograft. Association with distal oversizing and sealing length was analyzed. Results Consecutive patients with a total of 52 common iliac arteries were included in the study (mean age 74.9 ± 6.8 years, four women (7.7%)). The mean follow-up was 3.1 years. The mean iliac diameter increased from 15.5 to 17.1 mm ( p < .001) in the first control computed tomography angiography and to 18.7 mm ( p < .001) in the last available computed tomography angiography. No endograft (Endurant by Medtronic (24/52; 46%), Excluder de Gore (23/52; 44%), Zenith by Cook (5/52; 9%)) was associated with dilatation ( p = .066) or iliac retraction ( p = .591). Two type Ib endoleaks were found (3.8%) and successfully treated with distal graft extension. An iliac branch retraction of ≥5 mm was identified in seven cases (13%). Iliac arteries treated with limbs of ≥24 mm in diameter dilated significantly more than the rest of limbs (5.37 mm versus 3.12 mm; p = .022). In the last available imaging, iliac dilatation was ≥20% in 28 cases (53.8%) and had exceeded the diameter of the implanted endograft in 20 cases (38.4%). Iliac dilatation (OR 15.11 per mm, p = .025) was identified as a risk factor for retraction ≥5 mm. Conclusion Iliac dilatation and endograft limb retraction are common findings after endovascular aneurysm repair despite the use of new generation endografts. Optimizing the iliac sealing length and meticulous computed tomography angiography surveillance are recommended especially in case of use ≥24 mm iliac stent-grafts to prevent possible complications.

scholarly journals Symptomatic Aortic Endograft Occlusion in a 70-year-old Male

2020 ◽  
Vol 4 (3) ◽  
pp. 474-475
Author(s):  
Jose Cardenas ◽  
Babak Khazaeni
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Lower Extremity ◽  
Computed Tomography Angiography ◽  
Endovascular Aneurysm Repair ◽  
Lower Extremity Weakness ◽  
Case Presentation ◽  
Aneurysm Repair ◽  
Axillobifemoral Bypass ◽  
Leg Ischemia

Case Presentation: A 70-year-old male with prior aorta endovascular aneurysm repair presented with progressive lower extremity weakness over the course of several hours. There was noted loss of palpable bilateral femoral pulses in the emergency department. Computed tomography angiography revealed a kinked and occluded aortic endograft. He subsequently underwent successful axillobifemoral bypass revascularization. Discussion: Kinking of endograft limbs and occlusion has been reported in a small percentage of patients. Bilateral leg ischemia due to aortic endograft occlusion is rare.

scholarly journals Time-Enhancement Curve of Four-Dimensional Computed Tomography Predicts Aneurysm Enlargement with Type-II Endoleak after Endovascular Aneurysm Repair

Aorta ◽  
2020 ◽  
Vol 08 (02) ◽  
pp. 029-034
Author(s):  
Yunosuke Nishihara ◽  
Kota Mitsui ◽  
Shinya Azama ◽  
Daisuke Okamoto ◽  
Manabu Sato ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Equilibrium Phase ◽  
Endovascular Aneurysm Repair ◽  
Three Dimensional ◽  
Type Ii ◽  
Ct Scanner ◽  
Stable Group ◽  
Ct Number ◽  
4D Ct ◽  
Aneurysm Repair

Abstract Objective We investigated the hemodynamic features of Type-II endoleaks after endovascular aneurysm repair (EVAR) using four-dimensional (4D) computed tomography (CT) to identify patients with aneurysm enlargement. Methods During a 13-month period (January 2017–January 2018) at our institution, we performed 4D-CT examinations in 13 patients after EVAR because of suspected Type-II endoleaks. Three patients were excluded from the study because of other endoleaks or absence of detectable endoleaks. The ramaining 10 patients were divided into two groups: enlargement group (n = 4), in which the aneurysm volume increased, and stable group (n = 6), in which the aneurysm remained stable or shrank. A CT scanner and three-dimensional workstation were used. All images were obtained using a consistent protocol (22 phase scans using the test bolus tracking method). We analyzed the hemodynamics of the endoleak cavity (EC) relative to those of the aorta and evaluated the time-enhancement curves (TECs) using measurement protocols. The strengths of correlations between these factors in the two groups were analyzed statistically. Results TECs in the enlargement group showed a more gradual curve, and the upslope, the gradient of TEC in the ascending phase and the upslope index were significantly more gradual than those in the stable group (p = 0.0247, 0.0243). The EC washout and the EC washout index were also more gradual than in the stable group's (p = 0.019, 0.019). The enhancement duration was longer in the former than in the latter (80%, p = 0.0195; 70%, p = 0.0159; 60%, p = 0.0159). The CT number in the equilibrium phase was larger in the enlargement group than in the stable group (p = 0.019). Conclusion The 4D-CT is useful for predicting aneurysm enlargement with Type-II endoleaks after EVAR.

scholarly journals U-Shape Kissing Chimney Thoracic Endovascular Aneurysm Repair for a Traumatic Arch Rupture in a Polytraumatized Patient

Aorta ◽  
2015 ◽  
Vol 03 (01) ◽  
pp. 41-45 ◽  
Author(s):  
Jeroen Hendriks ◽  
Tim Brits ◽  
Thijs Van der Zijden ◽  
Koen Monsieurs ◽  
Dina de Bock ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Endovascular Aneurysm Repair ◽  
High Impact ◽  
Computed Tomography Scan ◽  
Polytraumatized Patient ◽  
Subarachnoid Bleeding ◽  
Thoracic Endovascular Aneurysm Repair ◽  
Aneurysm Repair ◽  
Tomography Scan

AbstractAn 18-year-old male patient was admitted to our hospital because of a high impact trauma. A computed tomography scan showed massive mediastinal bleeding due to a posteriorly located rupture of the aortic arch with formation of a pseudoaneurysm. Although urgent repair was indicated, open cardiac surgery was not feasible, as this would involve full heparinization in a patient with subarachnoid bleeding. The chosen solution was to perform a percutaneous thoracic endovascular aneurysm repair (TEVAR) and a kissing chimney procedure using a U-shape configuration.

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