Endovascular Repair of Aortic Aneurysms in the Presence of a Horseshoe Kidney

1998 ◽  
Vol 5 (3) ◽  
pp. 278-281 ◽  
Author(s):  
Ian K. Loftus ◽  
Matthew M. Thompson ◽  
Guy Fishwick ◽  
Jonathan R. Boyle ◽  
Peter R.F. Bell
Keyword(s):  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Horseshoe Kidney ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Renal Vasculature ◽  
Abdominal Aortic ◽  
Renal Vessel ◽  
History Of ◽  
Male Patients

Purpose: To report two cases of endovascular aortic aneurysm exclusion in patients with a horseshoe kidney. Methods and Results: Two male patients, one with a known horseshoe kidney and history of multiple previous laparotomies, presented with abdominal aortic aneurysms of approximately 6-cm diameter. Each was treated with a tapered aortomonoiliac polytetrafluoroethylene graft secured proximally with a Palmaz balloon-expandable stent. The endograft was sutured distally to a Dacron femorofemoral crossover graft. An anomalous renal vessel was sacrificed in one case. The aneurysms were successfully excluded, and the patients recovered without sequelae. Conclusions: Endovascular repair should be considered as a treatment option in patients with aortic aneurysm in the presence of a horseshoe kidney, particularly if the renal vasculature can be wholly preserved.

scholarly journals Family history of aortic aneurysm is an independent risk factor for more rapid growth of small abdominal aortic aneurysms in Japan

2015 ◽  
Vol 61 (2) ◽  
pp. 287-290 ◽  
Author(s):  
Atsushi Akai ◽  
Yoshiko Watanabe ◽  
Katsuyuki Hoshina ◽  
Yukio Obitsu ◽  
Juno Deguchi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Family History ◽  
Aortic Aneurysm ◽  
Rapid Growth ◽  
Independent Risk Factor ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
History Of

Adenosine-Induced Transient Cardiac Asystole Enhances Precise Deployment of Stent-Grafts in the Thoracic or Abdominal Aorta

1996 ◽  
Vol 3 (3) ◽  
pp. 270-272 ◽  
Author(s):  
Gerald Dorros ◽  
Joel M. Conn
Keyword(s):  
Blood Flow ◽  
Aortic Aneurysm ◽  
Abdominal Aorta ◽  
Endovascular Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Aortic Flow ◽  
Stent Grafts ◽  
Abdominal Aortic ◽  
Second Period

Purpose: To present a cardiac asystole technique that assists in the accurate deployment of stent-grafts during endovascular repair of thoracic or abdominal aortic aneurysms. Technique: In the anesthetized patient, trial doses of intravenous adenosine are delivered until a ≥ 20-second period of asystole is recorded. The endograft procedure then proceeds until the device is ready for deployment. The predetermined dose of adenosine is administered, and the device is deployed during asystole. Adenosine-induced transient asystole has been utilized in 16 patients undergoing balloon-expandable endograft exclusion of 6 thoracic aortic and 10 abdominal aortic aneurysms. Asystole lasted for 20 to 30 seconds, during which time the devices were accurately deployed without interference from the aortic flow. There were no clinical sequelae of this technique in any patient. Conclusions: Pharmacologically induced transient asystole appears to be a safe maneuver to preclude endograft movement by systolic blood flow. The technique permits precise placement of balloon-expandable stent-grafts and is applicable to self-expanding devices as well. Interventionists may wish to incorporate adenosine-induced asystole into their aortic aneurysm exclusion procedures.

Surgical Treatment of Abdominal Aortic Aneurysms Associated with Horseshoe Kidney

Vascular ◽  
2006 ◽  
Vol 14 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Onur Göksel ◽  
Bayer Çınar ◽  
Gürkan Kömürcü ◽  
Sinan Ahin ◽  
Tunc Eren
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Horseshoe Kidney ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Fluid Replacement ◽  
Aneurysm Surgery ◽  
Preoperative Serum ◽  
Abdominal Aortic ◽  
Aortic Aneurysm Surgery

Abdominal aortic aneurysm surgery associated with a horseshoe kidney (HSK) is a serious technical challenge for the surgeon. We reviewed our experience with 127 patients electively operated on between 1990 and 2004 for abdominal aortic aneurysm. Pre- and perioperative medical, surgical, and radiologic data were retrospectively reviewed. Preoperative diagnosis was achieved with computed tomography with or without angiography or with additional conventional aortography. Seven patients were recognized to have had a HSK, with a mean age of 67.29 ± 2.43 years. Preoperative serum creatinine levels were similar in patients with or without HSK (1.0 ± 0.08 vs 0.9 ± 0.12 mg/dL; not significant). In five of the patients with HSK, reimplantation of the anomalous renal artery was necessary. In all 127 patients, hospital mortality consisted of 5 patients, none of whom had an HSK. Dealing with HSK seemed to increase aortic clamp times (30.43 ± 3.55 vs 27.04 ± 3.92 minutes; p < .05) slightly. Patients with or without HSK were given similar amounts of intravenous fluid replacement (2,214.2 ± 441.3 vs 1,923.3 ± 433.6 mL/patient; not significant) and allogeneic blood transfusion (0.71 ± 0.49 vs 0.9 ± 0.4 U/patient; not significant) and had a similar intensive care unit stay. Abdominal aortic aneurysms associated with HSK have been managed without division of the isthmic tissue. The left retroperitoneal approach provided adequate exposure for all patients with HSK.

scholarly journals Prospective Ultrasound Screening of Men with Cerebrovascular Disease for Abdominal Aortic Aneurysms

2020 ◽  
pp. 145749692091726
Author(s):  
V. Vänni ◽  
J. Turtiainen ◽  
U. Kaustio ◽  
J. Toivanen ◽  
M. Rusanen ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Cerebrovascular Disease ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Maximum Diameter ◽  
Infrarenal Aorta ◽  
Ultrasound Screening ◽  
Abdominal Aortic ◽  
Male Patients

Background: The prevalence of abdominal aortic aneurysms is higher in population with other vascular comorbidities, especially among men. Utility of screening among patients with cerebrovascular disease is unclear. Objective: To determine the prevalence of abdominal aortic aneurysm in male patients with diagnosed cerebrovascular disease manifested by transient ischemic attack or stroke. Material and Methods: Between May 2013 and May 2014, all consecutive male patients undergoing carotid ultrasound in single tertiary center with a catchment area of 179,000 inhabitants were evaluated for ultrasound screening of abdominal aortic aneurysm. Abdominal aortic aneurysm was defined as maximum diameter of infrarenal aorta 30 mm or more. Results: Of 105 (n = 105) consecutively evaluated male patients, only 69% (n = 72) were eligible for the study and underwent aortic screening. Reason for ineligibility was most often poor general medical condition (n = 29). Mean age of screened patients was 66 years (SD 9.8 years). Half of the screened patients suffered stroke (n = 36). The incidence of abdominal aortic aneurysm was 5.6% (n = 4). All found abdominal aortic aneurysms were small and did not require immediate surgical intervention. During a follow-up period of over 4 years, none of the aneurysms exhibited tendency for growth. Conclusion: The male population with cerebrovascular disease is comorbid and frail. Only, moderate prevalence of abdominal aortic aneurysms can be found in this subpopulation.

Long-term outcomes and factors influencing late survival following elective abdominal aortic aneurysm repair: A 24-year experience

Vascular ◽  
2015 ◽  
Vol 24 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Manar Khashram ◽  
Julie S Jenkins ◽  
Jason Jenkins ◽  
Allan J Kruger ◽  
Nicholas S Boyne ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Abdominal Aortic Aneurysms ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Background Abdominal aortic aneurysms can be either treated by an open abdominal aortic aneurysm repair or an endovascular repair. Comparing clinical predictors of outcomes and those which influence survival rates in the long term is important in determining the choice of treatment offered and the decision-making process with patients. Aims To determine the influence of pre-existing clinical predictors and perioperative determinants on late survival of elective open abdominal aortic aneurysm repair and endovascular repair at a tertiary hospital. Methods Consecutive patients undergoing elective abdominal aortic aneurysm repair from 1990 to 2013 were included. Data were collected from a prospectively acquired database and death data were gathered from the Queensland state death registry. Pre-existing risks and perioperative factors were assessed independently. Kaplan–Meier and Cox regression modeling were performed. Results During the study period, 1340 abdominal aortic aneurysms were repaired electively, of which 982 were open abdominal aortic aneurysm repair. The average age was 72.4 years old and 81.7% were males. The cumulative percentage survival rates for open abdominal aortic aneurysms repair at 5, 10, 15 and 20 years were 79, 49, 31 and 22, respectively. The corresponding 5-, 10- and 15-year survival rates for endovascular repair were not significantly different at 75, 49 and 33%, respectively (P = 0.75). Predictors of reduced survival were advanced age, American Society of Anaesthesiology scores, chronic obstructive pulmonary disease, renal impairment, bifurcated grafts, peripheral vascular disease and congestive heart failure. Conclusions Open repair offers a good long-term treatment option for patients with an abdominal aortic aneurysm and in our experience there is no significant difference in late survival between open abdominal aortic aneurysms repair and endovascular repair. Consideration of the factors identified in this study that predict reduced long-term survival for open abdominal aortic aneurysms repair and endovascular repair should be considered when deciding repair of abdominal aortic aneurysm.

scholarly journals The Fate of the Superior Mesenteric Artery in Fenestrated Endovascular Repair of Complex Abdominal Aortic Aneurysms

2019 ◽  
Vol 2 (1) ◽  
pp. 38-39
Author(s):  
Yongcheng Xu ◽  
Yukun Li
Keyword(s):  
Aortic Aneurysm ◽  
Superior Mesenteric Artery ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Clinical Complications ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Issues related to the superior mesenteric artery (SMA) in fenestrated endovascular aortic aneurysm repair (f-EVAR), such as misalignment of the endograft and bridging devices-associated complications, are rarely reported. Moreover, the absence of autopsies in the majority of patients who died in the published series makes a possible correlation with occlusion of the SMA unknown. Current studies that reported on f-EVAR were reviewed accordingly, aiming to improve our understanding of the natural course of the SMA in fenestrated technology and to explore the associated clinical complications.

Abdominal aortic aneurysm (AAA)

2018 ◽  
pp. 461-468
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Incidental Findings ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Endovascular Stents ◽  
Abdominal Aortic ◽  
History Of ◽  
Old Men

Abdominal aortic aneurysms (AAA) are mostly asymptomatic and incidental findings on routine scans. The national screening programme currently offers scans to 65-year-old men. This chapter explores the risk factors and natural history of AAA. It describes the recommended investigations and management of AAA according to the presentation if symptomatic or size if asymptomatic. Treatment of AAA includes both traditional surgical repair or endovascular stents.

scholarly journals Aortic Aneurysm Eroding into the Spine

Aorta ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 068-069
Author(s):  
T. Rajab ◽  
Miriam Beyene ◽  
Farhang Yazdchi ◽  
Matthew Menard
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Mass ◽  
Abdominal Aortic Aneurysms ◽  
Aneurysm Rupture ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Acute Back Pain ◽  
History Of ◽  
Ruptured Abdominal Aortic Aneurysms

AbstractAortic aneurysms are usually asymptomatic until catastrophic rupture occurs. Ruptured abdominal aortic aneurysms classically present with acute back pain, shock, and a pulsatile abdominal mass. The natural history of some aortic aneurysms also includes a stage of contained rupture. This occurs when extravasation of blood from the ruptured aneurysm is contained by surrounding tissues. Here, the authors report the case of a chronic contained abdominal aortic aneurysm rupture that resulted in erosion of the spine.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

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