Endovascular treatment of two aortoduodenal fistulae

Vascular ◽  
2011 ◽  
Vol 19 (5) ◽  
pp. 277-281 ◽  
Author(s):  
Susana Cancer Pérez ◽  
Fernando Criado Galán ◽  
Enrique Puras Mallagray ◽  
Juan B Grau ◽  
Carmen Fiuza Marco
Keyword(s):  
Endovascular Treatment ◽  
Endovascular Repair ◽  
Close Contact ◽  
Chronic Obstructive ◽  
Aortoduodenal Fistula ◽  
Surgical Morbidity ◽  
Obstructive Pulmonary Disease ◽  
Aortic Pseudoaneurysm ◽  
Abdominal Aortic ◽  
Open Surgical Procedure

We report the endovascular treatment of two patients presenting with aortoduodenal fistulae. The first patient was a 66-year-old man admitted with hematemesis. He was on clopidogrel and had received a cryopreserved aortic graft for a mycotic abdominal aortic aneurysm five years earlier. Computed tomography (CT) showed aortic pseudoaneurysms in close contact with the duodenum. Endovascular repair was carried out. Twenty-seven months after the procedure the patient remains asymptomatic. The second patient was a 78-year-old man admitted with abdominal pain and nausea. CT revealed an abdominal aortic pseudoaneurysm and aortoduodenal fistula. He suffered from severe chronic obstructive pulmonary disease that greatly increased his surgical morbidity and mortality. An endovascular repair was performed under epidural anesthesia. The patient died of a postoperative pneumonia 38 days after surgery. These two cases illustrate the importance of endovascular aortic repair especially when an open surgical procedure is either difficult or impossible.

Successful Endovascular Repair of a Leaking Abdominal Aortic Aneurysm under Local Anesthesia

Swiss Surgery ◽  
2001 ◽  
Vol 7 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Lachat ◽  
Pfammatter ◽  
Bernard ◽  
Jaggy ◽  
Vogt ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Ct Scan ◽  
Local Anesthesia ◽  
Endovascular Repair ◽  
Anesthetic Management ◽  
High Risk Patient ◽  
Invasive Technique ◽  
Chronic Obstructive ◽  
Abdominal Aortic

Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. Patient and methods: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24mm x 12mm x 153mm) was implanted under local anesthesia. Results: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. Discussion: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

Stents for the Treatment of Aortic Aneurysms

1999 ◽  
Vol 82 (S 01) ◽  
pp. 171-175 ◽  
Author(s):  
D. Ebert ◽  
M. Langer ◽  
P. Uhrmeister
Keyword(s):  
Endovascular Treatment ◽  
Endovascular Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Imaging Modalities ◽  
Exclusion Criteria ◽  
Multicenter Studies ◽  
Abdominal Aortic ◽  
First Results

SummaryThe endovascular treatment of abdominal aortic aneurysms has generated a great deal of interest since the early 1990s, and many different devices are currently available. The procedure of endovascular repair has been evaluated in many institutions and the different devices are compared. The first results were encouraging, but complications like endoleak, dislocation or thrombosis of the graft occurred. By the available devices the stent application is only promising, if the known exclusion criteria are strictly respected. Therefore a careful preinterventional assessment of the patient by different imaging modalities is necessary. As the available results up to now are preliminary and the durability of the devices has to be controlled, multicenter studies are required to improve the devices and observe their long- term success in the exclusion of abdominal aortic aneurysms.

scholarly journals Tuberculous abdominal aortic pseudoaneurysm with renal and vertebral tuberculosis: a case and literature review

2014 ◽  
Vol 8 (09) ◽  
pp. 1216-1221 ◽  
Author(s):  
Chao Zhang ◽  
Bing Chen ◽  
Yongquan Gu ◽  
Tao Luo ◽  
Shengjia Yang ◽  
...  
Keyword(s):  
High Risk ◽  
Literature Review ◽  
Antibiotic Therapy ◽  
Endovascular Repair ◽  
Postoperative Course ◽  
Aortic Pseudoaneurysm ◽  
Abdominal Aortic ◽  
Very High

Tuberculous pseudoaneurysm of the aorta is rare and exposes patients to a very high risk of unpredictable rupture. To our best knowledge, only 32 cases have been reported related to all arterial systems from 1993 to 2013 in the literature. We report a 44-year-old male who presented with an aortic pseudoaneurysm and tuberculosis of the kidney and vertebrae. He underwent endovascular repair and antibiotic therapy for tuberculosis, combined with a bare stent implanted to seal endoleaks after endograft stenting. The postoperative course was uneventful and the patient recovered and lived well afterwards. Epidemiology, pathogenesis, presentation, management, and mortality of this entity were reviewed and discussed.

Aortic Anatomic Severity Grade Correlates with Midterm Mortality in Patients Undergoing Abdominal Aortic Aneurysm Repair

2019 ◽  
Vol 53 (4) ◽  
pp. 292-296 ◽  
Author(s):  
Zane Z. Young ◽  
Mark D. Balceniuk ◽  
Khurram Rasheed ◽  
Doran Mix ◽  
Antoinette Esce ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Resource Utilization ◽  
Survival Data ◽  
Abdominal Aortic Aneurysm Repair ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severity Grade ◽  
Abdominal Aortic ◽  
Receiver Operator Curve Analysis

Background: Anatomic severity grade (ASG) can be used to assess abdominal aortic aneurysm (AAA) anatomic complexity. High ASG is associated with complications following endovascular repair of AAAs and we have demonstrated that ASG correlates with resource utilization. The hypothesis of this study is that ASG is directly related to midterm mortality in patients undergoing AAA repair. Methods: Patients who underwent infrarenal AAA repairs between July 2007 and August 2014 were retrospectively reviewed and ASG scores were calculated using 3-dimensional computed tomography reconstructions. Perioperative mortalities (≤30 days) were excluded. The ASG value of 15 was chosen based on previous receiver–operator curve analysis, which showed that an ASG of 15 was predictive of postoperative complications and resource utilization. The 5-year survivors and mortalities were compared utilizing comorbidities, pharmacologic variables, and anatomic variables at or above the defined threshold. Results: A total of 402 patients (80% male and 96% Caucasian) with complete anatomic and survival data were included in the analysis. Mean ASG and age at the time of repair were 16 ± 0.15 and 73 ± 0.43 years old, respectively. The 5-year mortality was significantly associated with ASG >15 (hazard ratio [HR]: 1.504, confidence interval [CI]: 1.077-2.100, P < .017), hyperlipidemia (HR: 1.987, CI: 1.341-2.946, P < .001), coronary artery disease (HR: 1.432, CI: 1.037-1.978, P < .029), and chronic obstructive pulmonary disease (HR: 1.412, CI: 1.027-1.943, P < .034). Kaplan-Meier analysis demonstrated improved survival in the low score ASG ≤15 group at 1, 3, and 5 years (96% vs 93%, 81% vs 69%, and 53% vs 41%; P = .0182; Figure 1). Conclusions: Increasing aortic anatomic complexity as characterized by ASG >15 is an independent predictor of midterm mortality following elective infrarenal AAA repair. Therefore, it may be a useful tool for appropriate patient selection and risk stratification prior to elective infrarenal AAA repair.

High Risk Endovascular Aneurysm Repair: A Case Report

2017 ◽  
Vol 27 (10) ◽  
pp. 234-236
Author(s):  
S De Silva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Past History ◽  
Artery Bypass ◽  
Endovascular Aneurysm Repair ◽  
Chronic Obstructive ◽  
Bypass Grafting ◽  
Obstructive Pulmonary Disease ◽  
Abdominal Aortic ◽  
History Of ◽  
Aneurysm Repair

Mr AB is a 66-year old gentleman who presented for elective endovascular aneurysm repair (EVAR) following a routine screening scan identifying a 5.5cm abdominal aortic aneurysm (AAA). He had a past history of chronic obstructive pulmonary disease (COPD) with FEV1/FVC ratio of 48% on pre-assessment. He was hypertensive with a history of ischaemic heart disease (IHD), which has remained asymptomatic following coronary artery bypass grafting (CABG) eight years prior to this presentation.

Chronic obstructive pulmonary disease and abdominal aortic aneurysms

1993 ◽  
Vol 7 (4) ◽  
pp. 386-390 ◽  
Author(s):  
C.J.H.M. van Laarhoven ◽  
A.C.W. Borstlap ◽  
D.P. van Berge Henegouwen ◽  
F.M.L.H.G. Palmen ◽  
M.C.P.J. Verpalen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Abdominal Aortic

Abstract 258: Significant Predictors of Survival Following Endovascular Abdominal Aortic Aneurysm Repair

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Albeir Y Mousa ◽  
Mike Broce ◽  
Michael Yacoub ◽  
Mark Bates ◽  
Ali AbuRahma
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Cox Regression ◽  
Abdominal Aortic Aneurysm Repair ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Kaplan Meier ◽  
Surgery Patient ◽  
Abdominal Aortic ◽  
One Year

Objective: To identify significant predictors of survival after abdominal aortic aneurysm (AAA) repair. Methods: A retrospective review of the prospective endovascular aortic repair (EVAR) patient registry of the “Virginia’s group” maintained by the Society for Vascular Surgery Patient Safety Organization. Patients were classified into normal (eGFR ≥60 mL/min/1.73 m 2 ), moderate chronic renal insufficiency (CRI; eGFR ≥30-59) or severe CRI (eGFR <30). Kaplan-Meier and Cox-regression were used to measure and determine the predictors of survival. Results: A total of 6410 EVAR patients were included with an age of 73.5 ± 8.4 years (majority were male 81.2%), with an average follow-up of 2.3 ± 2.0 years. Compared to patients with eGFR 30-59 and >60, those with the lowest eGFR <30 had the highest rate of post-op MI (3.8 vs. 2.2 and 0.8%;p<0.001) and stroke+MI+30-day mortality (3.8 vs. 2.4 and 0.8%; p<0.001). One year mortality was the highest in patients with the lowest eGFR (<30) (5.7 vs. 2.1 and 1.0%, respectively). Overall, 5-year survival was 80.6%. Significant predictors of decreased survival were, unstable angina (Hazard Ratio (HR), 2.5; P =0.007), age (by decade) (HR, 1.6; p<0.001, oxygen-dependent chronic obstructive pulmonary disease (HR, 3.3; P<0.001), eGFR <30 (HR, 2.4; P<0.001) and eGFR 30-59 (HR, 1.5; p<0.001), while pre-operative statin and aspirin use were associated with increased survival (HR, 0.79 and 0.78; both p=0.014, respectively). Conclusion: Reduced renal function at baseline was found to be associated with increased post operative cardiovascular events and long-term mortality following EVAR. Increased monitoring of patients with CRI seems warranted.

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