Benefits and Role of Carbon Dioxide Angiography in Case of Misalignment Between Fenestration and Target Vessel During Fenestrated Endovascular Aneurysm Repair

2021 ◽  
pp. 152660282110329
Author(s):  
Emiliano Chisci ◽  
Stefano Michelagnoli ◽  
Fabrizio Masciello ◽  
Filippo Turini ◽  
Simone Panci ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Relative Position ◽  
Aortic Wall ◽  
Endovascular Aneurysm Repair ◽  
Target Vessel ◽  
Acute Occlusion ◽  
Complementary Role ◽  
Carbon Dioxide Angiography ◽  
Aneurysm Repair

Purpose: To report the benefits and the role of carbon dioxide (CO2) angiography in case of misalignment between fenestration and target vessel during fenestrated endovascular aneurysm repair (F-EVAR). Technique: During F-EVAR, misalignment between fenestration and target vessel is a potentially catastrophic complication. In 2 patients, we experienced that one of the target vessels were not visible during standard angiography in different projections after positioning a fenestrated graft and even after cannulation of the corresponding fenestration. In both cases, the graft was sealed to the aortic wall but not in the predictable position. Consequently, acute occlusion of the target vessel was hypothesized. However, CO2 angiography was useful to evaluate patency of the target vessel clarifying the relative position of the fenestration versus the target vessel. Rescue maneuvers were feasible under the guidance of CO2 angiography in order to obtain the cannulation of both renal arteries. In both cases, the procedure was successfully accomplished. Conclusion: In case of misalignment of a fenestration during F-EVAR and non-visualization of the target vessel with standard angiography, CO2 angiography could have the unique and complementary role of clarifying the patency and position of the target vessel. In addition, CO2 could guide the rescue maneuvers.

scholarly journals Use of carbon dioxide for therapeutic decision-making in endoleaks: a case report

2020 ◽  
Vol 19 ◽  
Author(s):  
Adalberto Batalha Megale ◽  
Cynthia de Almeida Mendes ◽  
Marcelo Passos Teivelis ◽  
Carolina Brito Faustino ◽  
Kauê Polizel Souza ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Decision Making ◽  
Endovascular Aneurysm Repair ◽  
Treatment Decision ◽  
Aortic Aneurysms ◽  
Therapeutic Decision ◽  
Type Ia ◽  
Therapeutic Decision Making ◽  
Aneurysm Repair

Abstract Endovascular aneurysm repair is currently the most frequently treatment modality for infrarenal aortic aneurysms. Endoleaks are the most common cause of reintervention after endovascular aneurysm repair. It is often unclear which type of endoleak is the correct diagnose, making the treatment decision difficult. We report the case of a 72-year-old man with an endoleak two years after endovascular aneurysm repair. Images suggested a type III endoleak, but this was not confirmed by contrast aortography. We proceeded with the investigation using aortography with carbon dioxide and observed a type IA endoleak. This was successfully treated by implantation of a proximal cuff. A review of the literature shows that the role of carbon dioxide in endoleak management is still unclear. We present a case in which carbon dioxide was essential to both diagnosis and therapeutic decision-making in a type IA endoleak.

scholarly journals Early pyrexia after endovascular aneurysm repair: are cultures needed?

2011 ◽  
Vol 93 (2) ◽  
pp. 111-113 ◽  
Author(s):  
L Corfield ◽  
J Chan ◽  
T Chance ◽  
N Wilson
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Blood Cultures ◽  
Stent Insertion ◽  
Out Of Hours ◽  
Microbiological Investigation ◽  
Significant Difference ◽  
Aneurysm Repair ◽  
Infective Complications ◽  
Post Implantation

INTRODUCTION The post-implantation syndrome after endovascular aneurysm repair (EVAR) is increasingly recognised. However, when non-vascular trainees are responsible for the care of these patients out of hours, many are investigated if pyrexial. This study assesses the role of microbiological investigations in pyrexia after endovascular aneurysm repair. PATIENTS AND METHODS The notes of 75 EVAR patients were reviewed retrospectively. The incidence of postoperative pyrexia and infective complications were calculated and the result of any cultures obtained. RESULTS Overall, 58 (77.3%) patients were pyrexial with 48 h of stent insertion. Twenty-four had blood cultures and 12 had urine cultures taken within 48 h of surgery. All of these cultures were negative. However, of those with a pyrexia after 48 h, one of nine blood cultures and two of 11 urine cultures grew organisms. Five pyrexial patients and one apyrexial patient developed a wound infection (a non-significant difference, P = 1.00). CONCLUSIONS Pyrexia within 48 h of EVAR is common. Microbiological investigation in the first 48 h in these patients is unrewarding. After 48 h, cultures are more likely to show growth. Although each patient must be assessed clinically for signs of sepsis, blood and urine cultures within 48 h of EVAR are generally unnecessary.

scholarly journals Role of aneurysm sac embolization during endovascular aneurysm repair in the prevention of type II endoleak-related complications

2013 ◽  
Vol 57 (4) ◽  
pp. 934-941 ◽  
Author(s):  
Michele Piazza ◽  
Paolo Frigatti ◽  
Paolo Scrivere ◽  
Stefano Bonvini ◽  
Franco Noventa ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Type Ii ◽  
Type Ii Endoleak ◽  
Aneurysm Repair

Cide-A Gene Expression in Patients with Obesity Qualified for Endovascular Treatment of Abdominal Aorta Aneurysm

2015 ◽  
Vol 86 (10) ◽  
Author(s):  
Marcin Feldo ◽  
Janusz Kocki ◽  
Jan Feldo ◽  
Sylwia Łukasik ◽  
Jacek Bogucki ◽  
...  
Keyword(s):  
Gene Expression ◽  
Endovascular Aneurysm Repair ◽  
The Body ◽  
Control Group ◽  
Study Group ◽  
Aorta Aneurysm ◽  
Group Play ◽  
Aneurysm Repair ◽  
Adipose Tissue Cells

Abstractgene and the genes of LRP group play a key role in the regulation of the body weight and lipid metabolism in mammals.was to define the role of. The study group consisted of 38 subjects, including 27 men and 11 women qualified for endovascular aneurysm repair (EVAR). The subjects with abdominal aortic aneurysm were enrolled in the study group, depending on the body mass index (BMI); in obese patients (BMI > 30). The control group (n = 16) included subjects without lipid disorders. One-step isolation of RNA from lymphocytes and adipose tissue cells was performed using the modified TRI method by Chomc-zynski and Sacchi, and then the gene expression was tested by real-time PCR.. The highest mean relative of the gene expression for. Due to the important role of the

scholarly journals Role of Simulation in Endovascular Aneurysm Repair (EVAR) Training: A Preliminary Study

2017 ◽  
Vol 65 (4) ◽  
pp. 1238
Author(s):  
A. Saratzis ◽  
T. Calderbank ◽  
D. Sidloff ◽  
M.J. Bown ◽  
R.S. Davies
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Preliminary Study ◽  
Aneurysm Repair

Intra- and Interobserver Variability of Target Vessel Measurement for Fenestrated Endovascular Aneurysm Repair

2010 ◽  
Vol 17 (3) ◽  
pp. 402-407 ◽  
Author(s):  
Olufemi A. Oshin ◽  
Andrew England ◽  
Richard G. McWilliams ◽  
John A. Brennan ◽  
Robert K. Fisher ◽  
...  
Keyword(s):  
Interobserver Variability ◽  
Endovascular Aneurysm Repair ◽  
Target Vessel ◽  
Aneurysm Repair
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