Novel technique of selective stent deployment in complicated thoracic aortic aneurysm.
Novel technique of selective stent deployment in complicated thoracic aortic aneurysm. Proc (Bayl Univ Med Cent). 2017 Jul;30(3):298-300 Authors: Young A, Kastner L, Vasquez J Abstract A 72-year-old woman presented with a thoracic aortic aneurysm that was found to have increased from 5.1 cm to 7.1 cm. Due to the increase in size, the aortic aneurysm required endovascular repair. After deployment of a GORE C-TAG stent graft, a distal type 1 endoleak was still present, requiring deployment of another stent to achieve total coverage. The aorta had an angled anatomical variation often associated with type 1 endoleaks causing technical difficulty with conventional deployment of the graft. By employing a novel Parachute technique, the graft was selectively deployed at the distal end, and the position was adjusted to fit the angulation of the aorta, followed by selective deployment of the proximal end. This selective deployment allowed for the adjustment necessary to effectively cover the endoleak. PMID: 28670062 [PubMed - in process]
Objectives The aim of this study was to compare image quality, conspicuity, and endoleak detection between single-energy low-kV images (SEIs) and dual-energy low-keV virtual monoenergetic images (VMIs+) in computed tomography angiography of the aorta after endovascular repair. Materials and Methods An abdominal aortic aneurysm phantom simulating 36 endoleaks (2 densities; diameters: 2, 4, and 6 mm) in a medium- and large-sized patient was used. Each size was scanned using single-energy at 80 kVp (A) and 100 kVp (B), and dual-energy at 80/Sn150kVp for the medium (C) and 90/Sn150kVp for the large size (D). VMIs+ at 40 k...
We would like to congratulate Antoniou et al. for their timely overview and meta-analysis, comparing long term outcomes of the randomised trials of open surgical repair (OSR) vs. endovascular aneurysm repair (EVAR).1 The strengths of this review are the inclusion of long term results from the OVER trial, published recently, and early resu lts from a small, but previously unidentified, Chinese randomised trial.2,3
CONCLUSIONS: So far, several balloon-expandable stent-grafts have been used as bridging stents during FEVAR but the ideal bridging stent-graft is far to be designed. The better understanding of the system FEVAR-native aorta and the strict collaboration and exchange of expertise between physicians and engineers are mandatory in order to increase the performances of these important components and to reduce re-interventions and complications in FEVAR. PMID: 31815375 [PubMed - as supplied by publisher]
This meta-analysis sought to identify the mortality and ambulatory state 30 days and one year post-operatively in octogenarians treated for ruptured abdominal aortic aneurysm (rAAA) by endovascular aneurysm repair (EVAR) or open repair (OR). rAAA is a life threatening emergency occurring increasingly in octogenarians. Surgical treatment, open or endovascular, offers the only chance of survival albeit with significant mortality and morbidity rates and a high burden to society. In order to make an informed decision on management, contemporary treatment outcomes should be known.
CONCLUSION: The 30 day and one year mortality rates for rAAA repair in octogenarians are similar to the outcome at all ages, with a significant survival advantage of EVAR over OR. Patients should therefore not be denied treatment of a rAAA based on age alone. PMID: 31810836 [PubMed - as supplied by publisher]
Introduction - Endovascular Aneurysm Repair (EVAR) has replaced open surgery in patients with suitable anatomy due to its low perioperative morbidity and mortality rates. In the context of an ageing population, EVAR has become the standard approach to managing aneurysmal disease in the elderly. However, long-term outcomes in older patients are unclear.
Introduction - Juxtarenal abdominal aortic aneurysm (JAAA) is defined as an infrarenal AAA that is adjacent to or involving the lower margin of the renal artery origins1. Recently, promising results have been reported in peer reviewed journals after fenestrated and chimney graft approaches to repair of JAAA2,3. Open repair, fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (Ch-EVAR) are effective methods to treat this condition, but the comparative effectiveness of these treatment modalities is unclear4.
Introduction - Female gender is associated with worse outcome in open as well in endovascular Aortic Aneurysm Repair. Few data are available on the influence of gender on endovascular treatment of thoraco-abdominal aortic aneurysm (TAAA) outcome. The aim of this study was to evaluate the effect of gender on outcome after TAAA endovascular repair using fenestrated and branched endograft (F/B-EVAR).
Introduction - Late survival is similar after open and endovascular abdominal aortic aneurysm repair (EVAR), despite lower perioperative mortality with EVAR1,2. Further re-interventions for graft complications are however more common following EVAR compared with open repair3. Long-term surveillance imaging is required following endovascular treatment to identify and treat complications. A significant proportion of patients have historically been found to become lost to surveillance efforts4 and have previously been found to have worse outcomes as a result 5.
The objective of the current study is to describe the Dutch experience with relining a failed open or endovascular AAA with EVAS.