Respiratory-induced changes in reno-visceral branch vessel morphology following fenestrated thoraco-abdominal aneurysm repair with the BeGraft balloon expandable covered stent

Purpose: To describe a modified up-and-over access technique for treatment of iliac artery aneurysms in patients with prior bifurcated stent-grafts for endovascular aneurysm repair (EVAR). Technique: This technique uses a coaxial 12-F flexible sheath that is docked with a through-and-through wire into a 7-F sheath advanced from the contralateral femoral approach. This maneuver allows both sheaths to be moved as a unit while maintaining position of the apex of the system as it loops over the flow divider, avoiding damage to or displacing the extant endograft. Once the 12-F sheath is positioned in the iliac limb of the aortic stent-graft and secured in place with the through-and-through wire, the repair is extended into the internal iliac artery using a bridging stent-graft or covered stent introduced via a coaxial sheath. Conclusion: The up-and-over technique with a flexible 12-F sheath mated with a 7-F sheath from the opposite side allows bilateral femoral access to be used for iliac branch device placement after prior aortic endograft procedures that create a higher, acutely angled bifurcation. Use of a through-and-through wire and a coaxial sheath for stent delivery creates a very stable platform for intervention.

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Kidney Failure After Occlusion of Accessory Renal Arteries in Endovascular Abdominal Aneurysm Repair

CardioVascular and Interventional Radiology ◽

10.1007/s00270-019-02342-2 ◽

2019 ◽

Vol 42 (12) ◽

pp. 1687-1694 ◽

Cited By ~ 3

Author(s):

K. Maurer ◽

N. Verloh ◽

L. Lürken ◽

F. Zeman ◽

C. Stroszczynski ◽

...

Keyword(s):

Kidney Failure ◽

Renal Arteries ◽

Abdominal Aneurysm ◽

Aneurysm Repair ◽

Accessory Renal Arteries

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High Postoperative Mortality After Elective Open Surgical Abdominal Aortic Aneurysm Repair in Hospitals with EVAR Preference and Lessons From an Instrumental Variable Analysis of the Dutch Surgical Abdominal Aneurysm Audit

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2019.09.010 ◽

2019 ◽

Vol 58 (6) ◽

pp. e547

Author(s):

Niki Lijftogt ◽

Anco Vahl ◽

Eleonora Karthaus ◽

Esmee van der Willik ◽

Sonia Amodio ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Instrumental Variable ◽

Postoperative Mortality ◽

Abdominal Aortic Aneurysm Repair ◽

Abdominal Aneurysm ◽

Instrumental Variable Analysis ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair ◽

Variable Analysis

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Endovascular Treatment of Aorta-Iliac Aneurysms with a Flared Iliac Limb

International Journal of Angiology ◽

10.1055/s-0039-1683411 ◽

2019 ◽

Vol 28 (01) ◽

pp. 057-063 ◽

Cited By ~ 2

Author(s):

Tomas Balezantis ◽

Stevo Duvnjak

Keyword(s):

Endovascular Treatment ◽

Stent Graft ◽

University Hospital ◽

Abdominal Aneurysm ◽

Graft Thrombosis ◽

Landing Zone ◽

Hospital Institution ◽

Aneurysm Repair ◽

Type 3

Endovascular abdominal aneurysm repair (EVAR) relies on the quality of the proximal and distal landing zone. Reinterventions are higher in patients with suboptimal landing zone. The study aimed to evaluate reintervention rate after endovascular treatment of an aorta-iliac aneurysm using the flared iliac limbs.The retrospective study included 179 patients treated with EVAR at a single university hospital institution from January 2011 to January 2014 of which 75 patients (42%) were treated with flared iliac limb stent graft and 104 patients (58%) were treated with a nonflared iliac limb stent graft. There were 165 male patients (92%), mean age was 75.8 ± 6.6 years.Thirty-six patients underwent secondary treatment accounting for overall reintervention rate of 20%. Endoleak type 1b occurred in 13 patients (7%), followed by endoleak type 1a in six patients (3%). Endoleak type 2 occurred in seven patients (4%) requiring the treatment due to abdominal aortic aneurysm (AAA) enlargement, endoleak type 3 in three patients (2%), and leg stent graft thrombosis in seven patients (4%). In 143 patients (80%), there were no secondary interventions during the follow-up period. Reintervention due to endoleak type 1b was statistically significantly higher in a flared iliac limb group (p < 0.02) with the rate of 7.2% compared with 1.9% rate in nonflared iliac limb group. The mean follow-up was 44.3 ± 20.4. Overall mortality was 33%.Flared iliac limb with a distal diameter of ≥ 20 mm, show a higher rate of iliac limb reintervention in a follow-up period due to endoleak type 1b.

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