Adjunctive Procedures for the Treatment of Proximal Type I Endoleak: The Role of Peri-Aortic Ligatures and Palmaz Stenting

2003 ◽  
Vol 10 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Elias Tzortzis ◽  
Robert J. Hinchliffe ◽  
Brian R. Hopkinson
Keyword(s):  
Endovascular Repair ◽  
Type I ◽  
Long Term Effects ◽  
Single Center Experience ◽  
Abdominal Aortic ◽  
Type I Endoleak ◽  
Secondary Procedures ◽  
Invasive Techniques

Purpose: To investigate the feasibility, efficacy, and long-term effects of peri-aortic ligatures and Palmaz stenting used to treat proximal type I endoleak after endovascular repair (EVR) of abdominal aortic aneurysm (AAA). Methods: An 8-year single-center experience with proximal type I endoleak was reviewed; the records of the 55 identified cases were examined to ascertain the methods of treatment used. Among these, all 22 patients who were treated with peri-aortic ligatures and Palmaz stenting were segregated for analysis. Results: The 22 patients (14 men; mean age 74.6 years, range 66–85) with proximal type I endoleak (18 early, 4 late) selected for analysis underwent 23 secondary procedures: 15 involving peri-aortic ligatures and 8 Palmaz stent implantations. Of the 18 early endoleaks, 11 were treated intraoperatively and 7 were observed. Ten (45%) patients died within 30 days of endoleak treatment: 8 had early endoleaks. Five of the 10 deaths occurred in patients successfully treated with peri-aortic ligatures (3/10) or Palmaz stenting (2/7). The 12 (54%) surviving patients suffered no aneurysm-related deaths or secondary endoleaks over a median follow-up of 20 months (range 4–75) Conclusions: Endoleak is an important mode of failure after endovascular repair. Peri-aortic ligatures and Palmaz stenting are feasible techniques for the treatment of proximal endoleak; however, the perioperative mortality of peri-aortic ligatures was higher when compared with other less invasive techniques. In contrast to other therapeutic options, these methods are more effective in the short and medium term.

Uncovered Chimney Stent Graft for Renal Arteries With the Nellix Endovascular Aneurysm Sealing Technique

2017 ◽  
Vol 52 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Luca Garriboli ◽  
Antonio Maria Jannello
Keyword(s):  
Aortic Aneurysms ◽  
Type I ◽  
Abdominal Aortic ◽  
Vessel Patency ◽  
Type I Endoleak ◽  
Procedural Costs ◽  
Endovascular Approach ◽  
Access Complications

Purpose: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs). Case Report: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration. ChEVAS was performed successfully with the novel addition of uncovered chimney stents to further reduce costs and possibly improve target vessel patency. JAAA exclusion and visceral vessel patency was confirmed at 18-month follow-up. Conclusion: ChEVAS with bare chimney stents is technically less complex, potentially reduces access complications and procedural costs, and may improve long-term patency compared to alternative techniques. Results at 18 months seem promising, but strict follow-up is necessary as the long-term durability is unknown.

Type I Endoleak Five Year after Endovascular Repair of Abdominal Aortic Aneurysm

2011 ◽  
Vol 27 (2) ◽  
pp. 76-79 ◽  
Author(s):  
Ei Jun Park ◽  
Hyoung Tae Kim ◽  
Won Hyun Cho ◽  
Young Hwan Kim
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Type I ◽  
Abdominal Aortic ◽  
Type I Endoleak

scholarly journals Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms

2017 ◽  
Vol 66 (5) ◽  
pp. 1379-1389 ◽  
Author(s):  
Theodorus G. van Schaik ◽  
Kak K. Yeung ◽  
Hence J. Verhagen ◽  
Jorg L. de Bruin ◽  
Marc R.H.M. van Sambeek ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Term Survival ◽  
Long Term Survival ◽  
Abdominal Aortic ◽  
Secondary Procedures

scholarly journals Microneurosurgery for Paraclinoid Aneurysms in the Context of Flow Diverters

2021 ◽  
pp. 47-53
Author(s):  
Sabino Luzzi ◽  
Mattia Del Maestro ◽  
Renato Galzio
Keyword(s):  
Flow Diverter ◽  
Type I ◽  
Long Term Effects ◽  
Paraclinoid Aneurysm ◽  
Paraclinoid Aneurysms ◽  
Type Ia ◽  
Flow Diverters

AbstractThe advent of flow diverter (FD) stents has apparently reduced the role of microneurosurgery for paraclinoid aneurysms despite sparse high-quality evidence about their long-term effects.The present study critically reviews the overall results of a microneurosurgical series of 57 paraclinoid aneurysms.Of these aneurysms, 47.4% were regular in size while 19.3 were giant. Barami type I was predominant. In 21 aneurysms a hemorrhagic onset occurred. Pterional approach with intradural anterior clinoidectomy was preferred by far. Clipping was possible in 91.2% of aneurysms and a high-flow bypass was the choice in five cases. An mRS of 0–2 was achieved in 77.3% of patients, typically <50 years old.Visual field appeared improved or unchanged in 36.3% and 63.6% of the symptomatic patients, respectively. In 76.1% of incidental aneurysms, campimetry was unaffected by surgery.A complete aneurysm exclusion was achieved in 93% of cases using a single procedure. No recurrences were documented on an average follow-up of 54.1 ± 34 months.Microneurosurgery is still a valuable, definitive, and durable option for Barami type Ia, Ib, or II paraclinoid aneurysm, especially in patients <50 years old and visually symptomatic. Conditions other than these are ideal candidates for FD stents.

Clinical Outcome and Technical Considerations of Late Removal of Abdominal Aortic Endografts: 8-Year Single-Center Experience

Vascular ◽  
2005 ◽  
Vol 13 (3) ◽  
pp. 135-140 ◽  
Author(s):  
Jean-Paul P. M. de Vries ◽  
Joost A. van Herwaarden ◽  
Tim Th. Overtoom ◽  
Jan Albert Vos ◽  
Frans L. Moll ◽  
...  
Keyword(s):  
Open Repair ◽  
Surgical Intervention ◽  
Type I ◽  
Midline Incision ◽  
Mortality And Morbidity ◽  
Single Center Experience ◽  
Proximal Migration ◽  
Abdominal Aortic ◽  
Type I Endoleak

During an 8-year period, 355 patients underwent endovascular repair of mainly true (97%) infrarenal aneurysms. After a mean follow-up of 48 months, 11 (3.1%) patients required conversion to open repair and 10 were eligible for open surgical intervention. Via a midline incision, explantation of the endograft was performed by using an infrarenal aortotomy. Explantation was done for rupture in four patients (40%), with a marked difference in mortality rates between acute (50%) and elective (0%) explantations. The main reason for explantation was proximal type I endoleak caused by (1) malposition of the device, (2) proximal migration of the endograft, and (3) dislodgment of a tube endograft that followed former central reconstruction. Proximal migration is most worrisome and demands preventive endovascular reintervention. The mortality and morbidity rates of elective explantation are acceptable. When delayed conversion is indicated, priority has to be given to operate on these patients.

scholarly journals A rare case of aortocaval fistula caused by type I endoleak after endovascular repair of abdominal aortic aneurysm

2018 ◽  
Vol 100 (8) ◽  
pp. e220-e222
Author(s):  
W Cheng ◽  
Y Yuan
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Rare Case ◽  
Vena Cava ◽  
Covered Stents ◽  
Type I ◽  
Aortocaval Fistula ◽  
Abdominal Aortic ◽  
Type I Endoleak

In this rare case, an aortocaval fistula caused by a type I endoleak following endovascular repair of an abdominal aortic aneurysm (AAA) in a 75-year-old man was treated successfully with repeat endovascular aortic stent implantation. Postoperatively, the patient’s symptoms were significantly improved, and angiography at nine months showed no endoleak in the aneurysm and no occlusion in the compressed inferior vena cava. Endovascular interventional surgery may be a safe and effective approach to treating AAA with concomitant aortocaval fistula. The use of covered stents to isolate the fistula from the venous side may not be necessary in the first stage of surgery.

scholarly journals Endovascular Repair of Type I Endoleak Following Open Abdominal Aortic Aneurysm Repair

EJVES Extra ◽  
2005 ◽  
Vol 10 (5) ◽  
pp. 114-116
Author(s):  
P. Astarci ◽  
S.S. Zhou ◽  
R. McWilliams ◽  
S.D. Blair ◽  
J. Brennan ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Abdominal Aortic Aneurysm Repair ◽  
Type I ◽  
Abdominal Aortic ◽  
Type I Endoleak ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair
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