scholarly journals Lower extremity weakness after endovascular aneurysm repair with multibranched thoracoabdominal stent grafts

2015 ◽  
Vol 61 (3) ◽  
pp. 623-629 ◽  
Author(s):  
Julia D. Sobel ◽  
Shant M. Vartanian ◽  
Warren J. Gasper ◽  
Jade S. Hiramoto ◽  
Timothy A.M. Chuter ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Endovascular Aneurysm Repair ◽  
Stent Grafts ◽  
Lower Extremity Weakness ◽  
Aneurysm Repair

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 Endovascular Aneurysm Sealing of a Collapsed and Thrombosed Aortic Stent-Graft With Renovisceral Chimney Stent-Grafts

2018 ◽  
Vol 26 (1) ◽  
pp. 72-75
Author(s):  
Fabien Lareyre ◽  
Claude Mialhe ◽  
Carine Dommerc ◽  
Juliette Raffort
Keyword(s):  
Stent Graft ◽  
Mesenteric Artery ◽  
Endovascular Aneurysm Repair ◽  
Stent Grafts ◽  
Aortic Thrombosis ◽  
Aortic Stent Graft ◽  
Aneurysm Repair ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-year-old man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.

Type IIIb Endoleak After Endovascular Aneurysm Repair Using the Zenith Stent Graft

2019 ◽  
Vol 53 (6) ◽  
pp. 515-519
Author(s):  
Toshiya Nishibe ◽  
Toru Iwahashi ◽  
Kentaro Kamiya ◽  
Masaki Kano ◽  
Keita Maruno ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aneurysm Rupture ◽  
Type I ◽  
Stent Grafts ◽  
System Type ◽  
Type Iiib ◽  
Type I Endoleak ◽  
Aneurysm Repair

We present 3 cases of type IIIb endoleak after endovascular aneurysm repair (EVAR) using the Zenith stent graft system. Type III endoleak, like type I endoleak, is a high-pressure, high-risk leak that increases sac pressure up to or even above arterial pressure, and is associated with an increased frequency of open conversions or risk of aneurysm rupture. Type IIIb endoleak is rare but there is much concern that the incidence of type IIIb endoleak is likely to increase hereafter; the mechanism of type IIIb endoleak is deterioration of graft fabric in conjunction with stent sutures. Type IIIb endoleak is difficult to diagnose before rupture. The possibility of type IIIb endoleak should be highly suspected when the continued growth of an excluded aneurysm sac without direct radiologic evidence is observed during follow-up. Type IIIb endoleak can be repaired by relining of the stent graft with additional stent grafts.

Iliac Branch Devices With Standard vs Fenestrated/Branched Stent-Grafts: Does Aneurysm Complexity Produce Worse Outcomes? Insights From the pELVIS Registry

2020 ◽  
Vol 27 (6) ◽  
pp. 910-916
Author(s):  
Konstantinos Spanos ◽  
Tilo Kölbel ◽  
Martin Scheerbaum ◽  
Konstantinos P. Donas ◽  
Martin Austermann ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Stent Grafts ◽  
Aortoiliac Disease ◽  
Type Iii ◽  
Kaplan Meier ◽  
Aneurysm Morphology ◽  
The Mean ◽  
Aneurysm Repair ◽  
Registry Database

Purpose: To compare the outcomes of iliac branch devices (IBD) used in combination with standard endovascular aneurysm repair (EVAR) vs with fenestrated/branched EVAR (f/bEVAR) to treat complex aortoiliac aneurysms. Materials and Methods: The pELVIS Registry database containing the outcomes of IBD use at 8 European centers was interrogated to identify all IBD procedures that were combined with either standard EVAR or f/bEVAR. Among 669 patients extracted from the database, 629 (mean age 72.1±8.8 years; 597 men) had received an IBD combined with standard EVAR vs 40 (mean age 71.1±8.0 years; 40 men) who underwent f/bEVAR with an IBD. The mean aortic aneurysm diameters were 46.4±13.3 mm in the f/bEVAR patients vs 45.0±15.5 mm in the standard EVAR cases. The groups were similar in terms of baseline clinical characteristics and aneurysm morphology. The Kaplan-Meier method was used to compare patient survival, IBD occlusion, type III endoleak, and aneurysm-related reinterventions in follow-up. The estimates are presented with the 95% confidence interval (CI). Results: Technical success was 100% in the f/bEVAR+IBD group and 99% in the EVAR+IBD group (p=0.85). The 30-day mortality was 0% vs 0.5%, respectively (p=0.66), while the 30-day reintervention rates were 7.5% vs 4.1% (p=0.31). The mean follow-up was 32.1±21.3 months for f/bEVAR+IBD patients (n=30) and 35.5±26.8 months for EVAR+IBD patients (n=571; p=0.41). The 12-month survival estimates were 93.4% (95% CI 93.2% to 93.6%) in the EVAR+IBD group vs 93.6% (95% CI 93.3% to 93.9%) for the f/bEVAR+IBD group (p=0.93). There were no occlusions or type III endoleaks in the f/bEVAR+IBD group at 12 months, while the estimates for freedom from occlusion and from type III endoleak in the EVAR+IBD group were 97% (95% CI 96.8% to 97.2%) and 98.5% (95% CI 98.4% to 98.6%), respectively. The 12-month estimates for freedom for aneurysm-related reintervention were 93% (95% CI 92.7% to 93.3%) in the EVAR+IBD group vs 86.4% (95% CI 85.9% to 86.9%) in the f/bEVAR+IBD patients (p=0.046). Conclusion: Treatment of complex aortoiliac disease with f/bEVAR+IBD can achieve equally good early and 1-year outcomes compared to treatment with IBDs and standard bifurcated stent-grafts, except for a somewhat higher reintervention rate in f/bEVAR patients.

The Turret Technique for Contralateral Gate Access

2018 ◽  
Author(s):  
S. Lowell Kahn
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Main Body ◽  
Stent Grafts ◽  
Hockey Stick ◽  
Repair Procedure ◽  
Cook Medical ◽  
Aneurysm Repair

Catheterization of the contralateral gate on the main body of aortic stent grafts is an important step of the endovascular aneurysm repair procedure. This step can be readily accomplished with appropriate pre- and intraprocedural planning. In cases in which the catheterization is challenging, several techniques can be utilized to overcome this difficulty. A Glidewire (Terumo Medical) together with a variety of catheters can be employed, most commonly either a hockey stick (e.g., Berenstein (AngioDynamics Inc., Latham, NY) and Kumpe (Cook Medical Inc., Bloomington, IN)) or reverse curve (e.g., Sos 1/2, Cook Medical Inc., Bloomington, IN) configuration. Occasionally, other catheters, such as a Van Schie (Cook Medical Inc., Bloomington, IN), may be useful when the gate is located away from the end of the contralateral sheath. This chapter delineates the Turret technique for rapid gate catheterization.

scholarly journals Long-term results after standard endovascular aneurysm repair with the Endurant and Excluder stent grafts

2020 ◽  
Vol 71 (1) ◽  
pp. 64-74 ◽  
Author(s):  
José Oliveira-Pinto ◽  
Nelson F.G. Oliveira ◽  
Frederico M. Bastos-Gonçalves ◽  
Sanne Hoeks ◽  
Marie Josee Van Rijn ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Long Term Results ◽  
Stent Grafts ◽  
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.

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