[Thoracoabdominal aneurysms]. Presse Med. 2018 Feb 22;: Authors: Soler R, Vallee A, Fabre D, Haulon S Abstract Endovascular treatment of thoracoabdominal aneurysms: what's new? Thoracoabdominal aneurysms (T-AAA) are aortic aneurysms that involve both the thoracic and abdominal segments of the aorta and its associated visceral branches. Although the first successful open repair was reported over 50 years ago, the risks of treatment remain considerable. As the first generations of devices available for endovascular aneurysm repair (EVAR) were relatively simple tubes or bifurcated grafts, initial attempts to extend the benefits of EVAR to patients with T-AAA lead to "hybrid solution". Good results with hybrid repairs have not been universal and the approach does not exploit all of the potential advantages of a "pure" endovascular approach (lesser surgical insult). This unmet need, together with rapid technological advances, has encouraged the development of custom-made endografts with fenestrations and/or branches (F-BEVAR) for extension into the visceral vessel ostia. F-BEVAR requires considerably more complex device design and planning than conventional EVAR. Deployment is more technically demanding and takes longer to complete. Thus, patient, aneurysm anatomy and surgical team selection is paramount. Favorable outcomes have been widely reported following T-AAA repair with F-BEVAR in expert centers; more complex aortic lesions such as ...
Conditions: Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracoabdominal; Acute Renal Failure; Acute Kidney Injury; Acute Kidney Failure; Acute Renal Insufficiency Intervention: Device: Medyria TrackCath System Sponsors: Medyria AG; StatConsult Gesellschaft für klinische und Versorgungsforschung mbH; Axxos GmbH; Worldwide Clinical Trials; Medical Mind RCS GmbH Completed
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
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 - Reporting standards described by Chaikof in 20021 and by Boyle in 20112 highlighted the need for appropriate aortic morphology analysis to determine abdominal aortic aneurysms (AAA) suitability for endovascular repair (EVAR) and to predict outcomes. Moreover, instructions for use provided by manufacturers to help select patients for EVAR, are mainly based on specific anatomic criteria.
Introduction - The use of fenestrated endovascular aneurysm repair (FEVAR) and branched endovascular aneurysm repair (BEVAR) for the treatment of complex abdominal aortic aneurysms (AAA) is rapidly increasing.1 Successful aneurysm exclusion and prevention of long-term treatment failure need to be balanced against the increased technical complexity and operative risks of more extensive procedures.2 The aim of this study was to analyse the linear relationships between the number of catheterised vessels and various procedural variables for endovascular treatments of complex aortic aneurysms using FEVAR and BEVAR, as compared ...
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).