scholarly journals Delayed Graft Dislocation After Thoracic Aortic Endovascular Repair

2015 ◽  
Vol 12 (2) ◽  
pp. 97-100 ◽  
Author(s):  
G Piffaretti ◽  
S Negri ◽  
S Ferraro ◽  
M Bossi ◽  
N Rivolta ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Aortic Disease ◽  
Anatomical Landmarks ◽  
Predisposing Factor ◽  
Imaging Protocol ◽  
Aortic Lesion ◽  
Landing Zone ◽  
Abdominal Aortic ◽  
And Migration

Background Endograft dislocation in thoracic aorta has not been widely studied.Objectives The purpose of this study is to analyze the incidence and predisposing factor in a single centre experience after 117 procedures.Method Between November 2000 and December 2011, all consecutive patients undergoing endovascular repair for descending thoracic or thoraco-abdominal aortic disease were identified. Follow-up imaging protocol included triple-phase CT-angiography at 1, 4, and 12 months, and annually thereafter. Migration was defined as proximal/ distal movements >10 mm relative to anatomical landmarks or any movement leading to symptoms or reintervention.Result We identified 117 patients. Mean follow-up was 32 months (range, 1-144). Overall, five (4.3%) patients with thoracic EG dislocation were identified. Dislocation was classified as collapse/infolding in 3 cases and migration in 2. Mean delay of the dislocation was 12.7 months. Only one patient developed symptoms and required an additional endograft. In the group of dislocated endografts, mean age (53 ± 20 vs. 68 ± 15, P = .032) and the diameter of the aortic lesion were lower (4.1cm ± 1.6 vs. 5.6cm ± 1.8, P = .069), and the proximal landing zone at “zones 2 and 3” were more frequently used (5 vs. 65, P = 0.81). All but one patient with collapse/infolding are still alive and doing well at a mean follow-up of 80 months.Conclusion Dislocation is an infrequent complication, but not so rare. Young age, small aortic diameter , and proximal sealing at the distal arch were the most important data associated with this complication.Kathmandu University Medical Journal Vol.12(2) 2014: 97-100

Ten-Year Follow-Up after Endovascular Repair of Traumatic Abdominal Aortic Rupture

2011 ◽  
Vol 6 (1) ◽  
pp. 51-53
Author(s):  
Stephen Nicholls ◽  
Riyad Karmy-Jones
Keyword(s):  
Endovascular Repair ◽  
Aortic Rupture ◽  
Graft Infection ◽  
Aortic Injury ◽  
Bowel Injury ◽  
Operative Repair ◽  
Abdominal Aortic ◽  
Aortic Injuries ◽  
And Migration

Blunt abdominal aortic injury is often associated with bowel injury that precludes operative repair because of the risk of graft infection. Endovascular repair has been reported but with limited follow-up. We present a case of a 15-year-old boy who underwent endovascular repair of blunt abdominal aortic rupture and whom we were able to follow up over a decade. Our experience with this case and three others, as well as the experience reported in the literature, suggests that endovascular repair is a reasonable option in the setting of concomitant bowel injury. The risk of over sizing, collapse, and migration may be less than that described for thoracic aortic injuries because there is no need to deploy the endograft across an angle.

scholarly journals Stent Frame Movement Following Endovascular Aneurysm Sealing in the Abdominal Aorta

2018 ◽  
Vol 26 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Asma Yafawi ◽  
Richard G. McWilliams ◽  
Robert K. Fisher ◽  
Andrew England ◽  
Maria Karouki ◽  
...  
Keyword(s):  
Abdominal Aorta ◽  
Endovascular Aneurysm Repair ◽  
Downward Movement ◽  
Landing Zone ◽  
Aneurysm Growth ◽  
And Migration ◽  
Definition Of ◽  
The Right ◽  
Instructions For Use

Purpose: To investigate the incidence and extent of stent frame movement after endovascular aneurysm sealing (EVAS) in the abdominal aorta and its relationships to aneurysm growth and the instructions for use (IFU) of the Nellix endograft. Methods: A retrospective single-center study was conducted to review the clinical data and computed tomography (CT) images of 75 patients (mean age 76±7.6 years; 57 men) who underwent infrarenal EVAS and had a minimum 1-year follow-up. The first postoperative CT scan at 1 month and the subsequent scans were used to measure the distances between the proximal end of the stent frames and a reference visceral vessel using a previously validated technique. Device migration was based on the Society of Vascular Surgery definition of >10-mm downward movement of either Nellix stent frame in the proximal landing zone; a more conservative proximal displacement measure (downward movement ⩾4 mm) was also recorded. Patients were categorized according to adherence to the old (2013) or new (2016) Nellix IFU. Aneurysm diameter was measured for each scan; a change ⩾5 mm was deemed indicative of aneurysm growth. Results: Over a median follow-up of 24 months (range 12–48), proximal displacement ⩾4 mm occurred in 42 (56%) patients and migration >10 mm in 16 (21%), with similar incidences in the right and left stent frames. Proximal displacement was significantly more frequent among patients whose anatomy did not conform to any IFU (p=0.025). Presence of aneurysm growth ⩾5 mm was observed in 14 (19%) patients and was significantly associated with proximal displacement ⩾4 mm (p=0.03). Conclusion: Infrarenal EVAS may be complicated by proximal displacement and migration, particularly when performed outside the IFU. The definition of migration used for endovascular aneurysm repair may be inappropriate for EVAS; a new consensus on definition and measurement technique is necessary.

Transcatheter, Endovascular Repair of Abdominal Aortic Aneurysm: Feasibility, Noninvasive Diagnosis, Problems, and Follow-Up

1999 ◽  
Vol 16 (6) ◽  
pp. 617-623
Author(s):  
ITZHAK KRONZON ◽  
MATHEW VARKEY ◽  
PAUL A. TUNICK ◽  
THOMAS RILES ◽  
ROBERT ROSEN
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Noninvasive Diagnosis ◽  
Abdominal Aortic

scholarly journals Endovascular repair of thoraco-abdominal aortic aneurysms by fenestrated and branched endografts†

2019 ◽  
Vol 56 (5) ◽  
pp. 993-1000 ◽  
Author(s):  
Enrico Gallitto ◽  
Gianluca Faggioli ◽  
Rodolfo Pini ◽  
Chiara Mascoli ◽  
Stefano Ancetti ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Hospital Mortality ◽  
Endovascular Repair ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
The Mean ◽  
Aneurysm Repair

Abstract OBJECTIVES Our objective was to report the outcomes of fenestrated/branched endovascular aneurysm repair of thoraco-abdominal aortic aneurysms (TAAAs) with endografts. METHODS Between January 2010 and April 2018, patients with TAAAs, considered at high surgical risk for open surgery and treated by Cook-Zenith fenestrated/branched endovascular aneurysm repair, were prospectively enrolled and retrospectively analysed. The early end points were 30-day/hospital mortality rate, spinal cord ischaemia and 30-day cardiopulmonary and nephrological morbidity. Follow-up end points were survival, patency of target visceral vessels and freedom from reinterventions. RESULTS Eighty-eight patients (male: 77%; mean age: 73 ± 7 years; American Society of Anesthesiologists 3/4: 58/42%) were enrolled. Using Crawford’s classification, 43 (49%) were types I–III and 45 (51%) were type IV TAAAs. The mean aneurysm diameter was 65 ± 15 mm. Custom-made and off-the-shelf endografts were used in 60 (68%) and 28 (32%) cases, respectively. Five (6%) patients had a contained ruptured TAAA. The procedure was performed in multiple steps in 42 (48%) cases. There was 1 (1%) intraoperative death. Five (6%) patients suffered spinal cord ischaemia with permanent paraplegia in 3 (3%) cases. Postoperative cardiac and pulmonary complications occurred in 7 (8%) and 12 (14%) patients, respectively. Worsening of renal function (≥30% of baseline level) was detected in 11 (13%) cases, and 2 (2%) patients required haemodialysis. The 30-day and hospital mortality rates were 5% and 8%, respectively. The mean follow-up was 36 ± 22 months. Survival at 12, 24 and 36 months was 89%, 75% and 70%, respectively. The patency of target visceral vessels at 12, 24 and 36 months was 92%, 92% and 92%, respectively. Freedom from reinterventions at 12, 24 and 36 months was 85%, 85% and 83%, respectively. CONCLUSIONS The endovascular repair of TAAAs with fenestrated/branched endovascular aneurysm repair is feasible and effective with acceptable technical/clinical outcomes at early/midterm follow-up.

Acute Abdominal Aortic Aneurysms: Cost Analysis of Endovascular Repair and Open Surgery in Hemodynamically Stable Patients with 1-year Follow-up

Radiology ◽  
2006 ◽  
Vol 240 (3) ◽  
pp. 681-689 ◽  
Author(s):  
Jacob J. Visser ◽  
Marc R. H. M. van Sambeek ◽  
M. G. Myriam Hunink ◽  
W. Ken Redekop ◽  
Lukas C. van Dijk ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Endovascular Repair ◽  
Open Surgery ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

Abdominal Aortic Aneurysm Wall Stresses After Endovascular Repair

2002 ◽  
Author(s):  
Elena S. Di Martino ◽  
Michel S. Makaroun ◽  
David A. Vorp
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Careful Consideration ◽  
Aneurysm Wall ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Endovascular Approach

The early benefits of an endovascular approach to abdominal aortic aneurysm (AAA) treatment has been reported by many authors [1,2]. One of the major advantages is that endovascular repair of AAA (EVAR) as opposed to traditional open surgery, is not a major abdominal surgery. EVAR has been shown to be associated with a death rate comparable to that of surgical repair [3]. In short term follow-up, EVAR is associated with fewer complications and a more rapid recovery [2]. On the contrary very limited data is available on long term follow-up of EVAR patients. Graft-related secondary interventions affect a consistent percentage of the treated cases. The EUROSTAR study [4] recently reported 13% of reintervention in 15.4 months. Our surgical unit reported 20.6% across 48 months in a recent review of 242 cases [3]. The frequence and type of reintervention, whose principal cause is endoleak or perigraft flow, requires careful consideration.

Endovascular Aneurysm Repair versus Open Repair in Patients with Abdominal Aortic Aneurysm

2017 ◽  
Author(s):  
F. Ben Pearce ◽  
Tze-Woei Tan ◽  
Wayne W. Zhang
Keyword(s):  
Endovascular Repair ◽  
Open Repair ◽  
Perioperative Complications ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Study Intervention ◽  
Complications And Mortality

This chapter provides a summary of the landmark EVAR Trial 1, which compared endovascular repair of abdominal aortic aneurysms (AAA) with open repair in patients judged to be fit for both open and endovascular repair. Although endovascular AAA (EVAR) repair was associated with lower perioperative complications and mortality than open surgical repair, after 4 years of follow-up the outcomes of the two approaches were similar. Follow-up at 15 years found EVAR had inferior late survival, necessitating lifelong surveillance of EVAR and reintervention if necessary. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

Sign in / Sign up

Export Citation Format

Share Document